Methodist Medical Center Foundation: George Mathews

Contents
COLETTA MANNING 2
GEORGE MATHEWS 18
DAVID MCCOY 39
METHODIST MEDICAL CENTER ORAL HISTORY:
COLETTA MANNING
Interviewed by William (Bill) J. Wilcox, Jr.
January 7, 2009
MR. WILCOX: This is an interview Bill Wilcox is having with Coletta Manning in her office on the afternoon of January 7, 2009. Coletta, I so much appreciate your agreeing to do this interview with you as part of our MMC book project. How about we start by your telling me a little about how you came to work at the hospital, when that was, what your position was, and perhaps a little bit about your training?
MRS. MANNING: OK. I grew up in Oak Ridge. As I was growing up here my family didn’t use this hospital because this was part of the land that my grandfather lived on, so he was pretty upset with the government for taking his land. When I came to work here he and the rest of the family started using the hospital at Oak Ridge. The first time I came to work here was in 1968, the summer of 1968. My husband at the time was in the Navy and it was the height in the Vietnam War so he was going back and forth to Vietnam. He would go to Vietnam and I would come back home here and work for nine or ten months, and then when he came back to the States for four or five months, we lived in California. I came to the hospital first in 1968, just worked for the summer, and worked as a staff nurse on the old 2 North on the 3 P.M. to 11 P.M. shift. It was the toughest unit in the hospital, no doubt. We had a lot of really, really sick patients. It was a very tough unit to work; it was a medical unit. When I came back to work in 1969, I had a brand new baby and I worked in the old ICU, which was on the third floor back at the end of the hall. It was a five bed unit, I worked 3 P.M. to 11 P.M., full time, and I was in there every night with just one LPN and a lot of prayers because we got every kind of thing you can possibly imagine in there. And we did not have full-time doctors in the Emergency Room, we didn’t have doctors around the clock in the hospital, so whenever we had an emergency or something like the patient going bad, it was really tough trying to find a doctor to get them there to help you. But it was the only way we knew. The next time he went to Vietnam and I came back in, I believe, is when we opened the Coronary Care Unit. It was the first coronary care unit that Methodist had had. I had had special training in coronary care and had opened two other coronary care units in Tennessee. One being in Murfreesboro back in 1966 and another one at the Navy Hospital in Memphis, I helped open that one. So I already had some coronary care training, I loved cardiac care -- that was really my first love. The rest of the staff that was hired for the Coronary Care Unit had not had that training so they went away for the training and I was working in the ICU while they went away. I think I am the last nurse still working here that opened that first coronary care unit. It was a four bed unit, all brand new. The nurses working in there even picked out the furniture, it was great, I loved it. We still did not have ED physicians; we didn’t have a code team like we have these days. So if a patient arrested, it was really up to who ever was working to take care of the patient. I can remember the very first patient that had to be defibrillated when I was on duty. We paged the code which was Dr. Emory then, and the only doctor in the house at the time, Sunday morning, and the only doctor in the house was Dr. Lewis F. Preston, the pediatrician. He came back and I remember him saying “Oh, this is amazing, this is just amazing;” you know because we had already defibrillated the patient and he was back. The patient was awake and talking.
MR. WILCOX: How wonderful.
MRS. MANNING: So it was really, really a good job; a great job.
MR. WILCOX: I have a note here in my file that some of the other nurses that started up coronary care were Alice McLaughlin?
MRS. MANNING: Alice McLaughlin is still my very dear friend.
MR. WILCOX: Helen McDonald and MaryAnn Dennis?
MRS. MANNING: I have no memory of the first person, but MaryAnn Dennis was here in the beginning, yes. I went to high school with MaryAnn.
MR. WILCOX: Is that so?
MRS. MANNING: Yes, so we graduated from high school together. Allis remains a very good friend, she lives in Kentucky. Others I remember that helped start coronary care in addition to myself, Allis McLaughlin, and Mary Ann Dennis, were Esther Weinberger, Mildred Parker, Mary Taylor, Mary Sue Dabbs, and Dorothy “Pete” Ralls.
MR. WILCOX: I am a past user of your coronary care unit, so I really thank you for setting that up!
MRS. MANNING: It was a wonderful thing, I really enjoyed that.
MR. WILCOX: Where did your career here go from there?
MRS. MANNING: From there, I guess in 1975, I came back to work full-time, I had three children by then and decided I needed to come back to work to get a rest! So I came back to work and went to work in the Intensive Care unit, by then it was combined with Coronary Care. There was an intensive care unit and a coronary care unit. I did that for maybe about nine months and then Betty Cantwell appointed me as manager of 4 North, the old 4 North which was a medical unit. The other side of 4 North was 4 South, pediatrics, and then the pediatric head nurse or clinical manager left and I ended up with looking after both pediatrics and the medical floors. I got a little bit of peds and little bit of medicine and then, whenever we opened 3 West, we opened the west wings. 3 West opened about 1977.
MR. WILCOX: Was that the acute care wing?
MRS. MANNING: No, it was 2 West, then 3 West. Two West actually opened first and then a year or so later 3 West opened. It was going to be Telemetry, Cardiac step-down, so I went there. It was a 58 bed unit and we had 4 telemetry monitors, so patients that got out of coronary care came up to our unit and I started the first cardiac rehab program.
MR. WILCOX: Wow, is that so?
MRS. MANNING: Yes, I did that. So it was, I loved that because I got my heart patients back that I loved so much.
MR. WILCOX: Really helped them get back on the street?
MRS. MANNING: And did the cardiac rehab, yes.
MR. WILCOX: I have been going to Rehab classes for eight years. That is a great service of MMC that we still have.
MRS. MANNING: The cardiac rehab I did was mostly education. We didn’t do a lot of the physical therapy part - that really didn’t come about until after that. Oh, gosh, I guess I stayed on 3 West, I was the first manager on 3 West and I was there till I believe 1987 and then I moved into Quality with Micki Camp and we were working with the medical staff on utilization reviews, where the insurance companies were demanding information about patients on a daily or an every other day basis. I did a lot of that. From there I became the Manager of Quality and now I am the Director of Clinical Effectiveness and have been in this role for, I don’t know, about 10 or 11 years now.
MR. WILCOX: Clinical Effectiveness?
MRS. MANNING: Yes, is what my title is.
MR. WILCOX: Is that the same as Outcomes Analysis?
MRS. MANNING: “Outcomes Management” is what we call it here, “Continuum of Care” is what it is called in some places, but in the Covenant System it is “Clinical Effectiveness.” Clinical Effectiveness and Quality, I believe is what we are “about.”
MR. WILCOX: In layman’s terms, do we just try to measure whether the hospital is doing their job they are supposed to do?
MRS. MANNING: I monitor a lot. I do a lot of work with the medical staff, their quality improvement is monitored. I do a lot -- I have case management where we monitor the core measures which are the required elements that we have to submit to the Federal Government every quarter as well as to the Joint Commission all that stuff, we do that. So I have responsibility for that, I also have responsibility for the social workers, and I have responsibility for our Capacity Management Center which is our bed flow and I have infection control and I have medical staff office and I have the Diabetes Center across the street, the outpatient Diabetes and Heart Failure and the Comprehensive Chest Clinic.
MR. WILCOX: Well you have your finger on top of most all the hospital operations?
MRS. MANNING: Well when you have been around this long, you know, I do a lot of work with the medical staff and I have been here as long as or longer than as most of them. I have children older than most of these guys now, so it is a great group to work with and I have a lot of fun working with them.
MR. WILCOX: That is wonderful. How about your any interactions with management? When you first came to the hospital in 1968 Marshall had just come; I guess he had just been here just a year and Ralph was here too?
MRS. MANNING: Yes. I knew Marshall and Ralph; I was heavily involved with Marshall in the first quality improvement effort that we had leading toward our winning the Tennessee Quality Award -- you know all the 4 years we won the level three, and the fifth year we finally won the big one. I worked on all of those, so I had pretty heavy interactions with Marshall and Ralph from the time I was a manager onward.
MR. WILCOX: Is it true Coletta that our hospital really was at the vanguard of this movement towards improved quality, weren’t we one of the first hospitals in the area to embrace this strategy --certainly very successful as witnessed the state award? It seems to me you all were “plowing new ground” with this concept that the hospital needed to be seriously concerned about the quality of the healthcare given, not just helping people get well but really worrying about the quality of how we did it. Can you say something about that?
MRS. MANNING: I sure can. I think we were plowing the new ground as far as healthcare. As a matter of fact the company that we worked with to first do quality improvement told us we were the first hospital that they had worked with.
MR. WILCOX: Qual-Pro? Chuck Holland?
MRS. MANNING: Yes. We were the first hospital and there was a fellow there that I can’t even remember his name now who decided to write a book about Quality and Healthcare and he and I had many, many conversations and faxes and phone calls back and forth about how you integrate widgets into people. We also and I did think I was more responsible than anybody in developing our program that we called “CareTrax.” And we were the first hospital in the area to do that.
MR. WILCOX: Can you tell me a little about CareTrax?
MRS. MANNING: What CareTrax is, is just a map for what is going to happen to you while you are in the hospital, so it maps out on day one, day two, day three exactly what medicines and treatment you were going to get.
MR. WILCOX: This is for each patient?
MRS. MANNING: It was for each diagnosis. So we started off with a surgical procedure, a total hip replacement because we do a lot of those and it was a fairly simple one to do. I had one of the doctors partner with me, one of the orthopods, so we started off to trial it just on his patients, but then I took it to the orthopedic section meeting of the medical staff and said “you know here is what we have done, I want you to be aware that you are going to be seeing it on the floors” and wonderful Dr. McMahon who happened to chair the orthopedic section at the time said “well can the rest of us use it?”
MR. WILCOX: Oh how great.
MRS. MANNING: So that was it. It took off immediately and we did things like reduce the length of stay from like eleven days to five days almost immediately. We reduced our cost, standardized the use of antibiotics, and all the other things -- and that is what quality is all about, it’s about standardization. It is decreasing variation and that is what we did with our first CareTrax programs, so they became quite prolific here because it wasn’t very long then before doctors including Dr. Stanley who would say, “Well can you do one for my ‘carotid endarterectomies’ so we just did them and I think we ended up doing about thirty-four procedures.
MR. WILCOX: But you were getting the medical staff on board, that was really the key to it wasn’t it?
MRS. MANNING: Oh yes and actually when Joint Commission came the next year or two years after we had implemented them the physician reviewer with the group said to the docs, “How did you get this, how did this happen?” And Dr. McMahon turned around and pointed at me and said, “She did it”. So it was great.
MR. WILCOX: So rewarding?
MRS. MANNING: Oh very much…
MR. WILCOX: It was a three-way win/win for the hospital and the doctors and the patients?
MRS. MANNING: And the patients because we gave copies of those Trax to the patients saying in layman’s terms, here is what is going to happen to you. If there was an opportunity we would meet with the patient pre-operatively, we did and told them here is what you will be on, here is what is happening.
MR. WILCOX: Take some of the fear out of the process?
MRS. MANNING: Absolutely. Absolutely, And that has evolved, I think they use that concept at least with our total joint center now and those patients are extremely satisfied. They absolutely know what is going to happen to them every minute.
MR. WILCOX: Do we know whether other hospitals in the area have picked up on what we learned.
MRS. MANNING: Well, when we joined Covenant the thing they wanted from us was our CareTrax. It is not the only thing but it was certainly one of the big things they wanted. They had heard of them because of nurses who worked at several different facilities…
MR. WILCOX: Moved around?
MRS. MANNING: They moved around and took a CareTrax with them. I had hospitals from Memphis, hospitals from Crossville that came over here, and said, “Show us your CareTrax, show us how it works, tell us how you did it, how did you get the docs on board.” all that kind of stuff. We don’t have CareTrax anymore because we have gone to electronic medical records, or a lot of it is electronic. We have now is what we call “Care Designs” and it is basically the same thing.
MR. WILCOX: Accomplishes the same thing?
MRS. MANNING: Right, it accomplishes the same thing. But we have all the Covenant facilities now on those.
MR. WILCOX: Great. Wasn’t that a really fine achievement?
MRS. MANNING: Yes, I think that was the one, the one thing that we were truly innovative in. Now 90-95% of the hospitals in the country have some kind of critical pathway or some kind of a system in place. They were actually developed by a nurse, a psychiatric nurse, and she just took the old engineering critical pathway and made it into a kinda medical pathway.
MR. WILCOX: Do you remember other management moves or things that you were involved with the nurses, things in which our hospital was really innovative with, in those years with Ralph and George?
MRS. MANNING: I think there were a lot of things that came about because of team activities. I was a facilitator, one of the first team facilitators and I facilitated many, many teams in this organization. I can remember very clearly one that I did it early on and it was about chest x-rays. The problem was the number of repeat chest x-rays that would have to be taken, where a physician would come in order a chest x-ray, it wouldn’t turn out very well and they would have to repeat it. Well you really don’t want to do that to people very much so --I’m not a radiology person -- I had no idea what was going on but the team had an idea that there was one thing that was causing it, but when we collected the data and worked it over the team we found out it was totally something else. Something totally different! So we found out that getting the data is so important -- it is so important --, and I always use a phase that I stole from W. Edwards Deming, who was one of the first proponents of statistics in management, his phrase was, “In God we trust, and from all others we require data.”
MR. WILCOX: From all others we require data?
MRS. MANNING: Yes, and I learned that early on that you really have to use this data driven approach. It has to be data driven. I think we have been pretty innovative with getting our medical staff on board with quality improvement. They understood early, early on about the importance of decreasing variation; they understood why CareTrax worked. I would have some of them come back to me and say. “This is just ‘cook-book’ medicine,” and I would say, “You know what, it is and all I want is your recipe because when you take a patient to surgery for an appendectomy there are certain things that you do every single time. That is the recipe. And that is what I want to put on your CareTrax so that we do it right every single time.” That is what quality is. If you improve the quality, your cost will decrease, your length of stay will decrease, and your patient will be happier and you will too. So I think we got our docs on board real early, and as I dealt with other facilities and with physicians from other facilities I thought, “Oh how lucky we are.” I would often come out of those meetings and say to some of our docs, “I sure am glad I work with you.” Because they were already there, we didn’t have to bring them on board like we did with some of the others.
MR. WILCOX: Medical schools, I gather, don’t teach this kind of data gathering or disciplined following of standardized procedures?
MRS. MANNING: No.
MR. WILCOX: Coletta, how do you get the new docs on board, that are coming in continuously to this system?
MRS. MANNING: When they come into here they get orientation with me and they spend a lot of time with me. I make up a notebook for them and I tell them here is what quality is, here is what we have done with it in the past, here is what we expect, here’s our anticipation. We have also aligned some of their goals - especially with contracted services - we try to align their goals with what our goals are. I have been educating them for three years, this is coming down the pike and you are going to have to do it too. Hospitals have to submit this kind of data now to regulators; you are going to have to do it too. Just from the very beginning and with some of those goals that we have said, you know like the use of Care Designs if they use the Care Designs they will met the core measures and I know from the data who has used the system and who has not and we give them feedback data. Paperwork for the last six months is what we send out to them, after I review it. So we give them lots of feedback when they come in, and I am generally having conversations with new docs real frequently, asking, “How is it going? What are you finding? Got any ideas?” And we actually recently hired, in the last six months, we hired one that came from Baptist in our hospitalist program and he brought a couple of forms that we thought were pretty good and so we revamped them just a little bit to meet our needs. He was happy because he had helped and saw his ideas accepted.
MR. WILCOX: You mean see something I got from somewhere else being used?
MRS. MANNING: Oh, absolutely I steal unashamedly.
MR. WILCOX: It must be kind of a shock for some of these new docs to be exposed to this as a requirement of being accredited with our hospital?
MRS. MANNING: Yes. You know a couple of years ago you would get a new doc out of school and you know they are fresh out school and, boy they are so anxious. They have been told to do things a certain way for so long, that they are so anxious to do it their own way but it doesn’t take them long to figure out that now when you are out here and you don’t have that Chief Resident looking down your shoulder or the attending physician looking down at everything, you realize you are on your own. Then they are ready for any help they can get. Maybe my age or my brazenness or something, but I just get after them, they are younger than my children.
MR. WILCOX: Of course you know when to be hard and when to be soft?
MRS. MANNING: You know I think they just trust me. I try to give them any help I can; you know when they say to me could I get so and so, even if it is not my job I try to get it for them. You know I want to give them back as much as I expect to get back from them.
MR. WILCOX: Well, looking back on all your years here, Coletta, what do you think most about in terms of happy experiences that you have had?
MRS. MANNING: I think the most exciting thing has been the change, in the advancement of technology, how fast it has advanced. I mean, I have been here 34 years full time and I think that when I came all of things we were doing were then “state of the art,” but when I look back and I see what we have now I think oh my God, how did we do that? How did we work in that unit taking care of five critically ill patients with one RN and one LPN and no physicians in the house? Yet we did it, so has been wonderful to see the changes in technology. It is wonderful to see that we have house physicians here all the time. It is marvelous to see that we have the great staff of intensivists, and that is pretty innovative in the area. There are very, very few community type hospitals in the country that have a full time intensivist program like we do and we’ve got top notch docs down there working with the critically ill patients that we get helicoptered into us from all around the area, so I think that is what is so surprising.
To think that I remember sitting up on the floor one time back when the hospital didn’t have a respiratory therapy department. Not many hospitals did, but even so we had a patient on a ventilator. I had never had a patient on a ventilator so us two nurses sat down one night up in the old CCU and took apart a ventilator and put it back together till we understood how it worked just in case we got a patient in that we had use it on. All because we did not have a respiratory therapist. Just to think. Wow, now not only do we have a respiratory department but we have a number of respiratory therapists. That is remarkable when I look back. Also remarkable are the things that we can do surgically now. When I got out of school if you had a cataract removed you stayed flat in bed on your back with sand bags on the side of your head, and could not move for two weeks. Now you have it done and go home in a couple hours. And all that change during the time of my career, and that is not like it was back in the 19th century. It is a short time that has gone so fast.
MR. WILCOX: Is the person that is here 38 years from now going be able to look back and see that we made some of the same big changes from where we are today?
MRS. MANNING: I am sure, if the government will let us stay fiscally stable, and if the government will quit taking back all our money. For instance, it is just amazing the amount of information that you get from a 32 slice MRI. And even more in a 64 - and you know about the time we get the 64 one set up I am sure there will be a 120 slice MRI out there or something. You know they just advance so rapidly.
MR. WILCOX: Wonderful. This has been exciting. What else do you want to talk about?
MRS. MANNING: Well, I was a little nervous, I have to say, when you came in because I wasn’t sure what I was going to talk about but…there is a lot. Well it has been interesting to sit through the number of hospital administrations that we have had, but I think we have done remarkably well with all of them. I think we are very lucky to have Mike Belbeck here now; one of the really nice things about this hospital the culture of the administration, it is always a first name basis, it is a friendly hospital.
MR. WILCOX: Easy, relaxed place to work?
MRS. MANNING: Yes, I mean I have had plenty of opportunities to go other places and I don’t think about them, not only because this is my home but because I love working with this medical staff. I love my job. I love the administrative people that I work with. I love my boss, you know and I love my staff. I have a wonderful, wonderful staff.
MR. WILCOX: That is a wonderful testimonial and that is what life ought to be but lots of times it does not. Isn’t that great?
MRS. MANNING: Just the day before yesterday I talked with a case manager who ended up with us after Baptist had their downsizing and she was talking about a physician that they worked with over there and the difference in the ones we work with here and this being a nice place to work. I said, “That is a nice thing to hear, because I have always felt that way.” Of course it has been a long time since I have worked anywhere else, but this is a nice place to be, a nice town to grow up in, it was great town to grow up in and I knew when I left, you know when I got married the first, the only time, I knew when I left if I had children I would come back here to raise them and I did.
MR. WILCOX: That is just very, very nice. I have certainly enjoyed chatting with you and this has been a great interview.
MRS. MANNING: Thank you.
MR. WILCOX: Thank you.
[End of Interview]
METHODIST MEDICAL CENTER ORAL HISTORY:
GEORGE MATHEWS
Interviewed by Pat Clark
August 20, 2008
MRS. CLARK: Pat Clark on August 20, 2008 interviewing George Mathews, former administrator of The Oak Ridge Hospital for the MMC Foundation's history project. George, tell me a little bit about your background I know you are a Virginian.
MR. MATHEWS: Yes, grew up at Front Royal, Warren County, Virginia. I went to school in Virginia. In fact, all of my schooling was in Virginia. I graduated from the Richmond Professional Institute (RPI) and the Medical College of Virginia Hospital Administration Program back in 1960.
MRS. CLARK: Your wife is?
MR. MATHEWS: Karol, she is from Iowa.
MRS. CLARK: Where did you meet?
MR. MATHEWS: We met in California.
MRS. CLARK: Were you working out there?
MR. MATHEWS: I was in the Navy. I met her while I was still in the Navy. Her brother and I were stationed together.
MRS. CLARK: How long was your service in the Navy?
MR. MATHEWS: I was in the Navy four years.
MRS. CLARK: Where did you go from the Navy?
MR. MATHEWS: To college. I came back to Virginia for college. We got married and decided not to make the Navy a career. I decided I better go find something to do. I went to college with the idea of actually going to work at Sears Roebuck and Company after completing college in retail management. During college a friend of mine, that I had known for years, was enrolled in the Medical College of Virginia School of Hospital Administration, and he and I got to talking about it. It looked interesting, so I decided go on to graduate school and try the medical field. That is how I got started in hospital administration.
MRS. CLARK: Ok, that led you into hospital administration. Did you stay in Virginia?
MR. MATHEWS: No, I spent the next 14 years after I graduated in Jacksonville, Florida, at Baptist Hospital in Jacksonville. I came to Knoxville in 1973 and worked for the Baptist Hospital here.
MRS. CLARK: What brought you to Oak Ridge?
MR. MATHEWS: Well, I was in the process of changing jobs. I went to work for Hospital Corporation of America (HCA) at Parkwest Hospital in Knoxville. I had gone out to Martin, Tennessee, as administrator of a small hospital in West Tennessee for HCA, and I was there about a year when I got a call from Ralph Lillard asking if I wanted to come back to East Tennessee. So we talked for a while, and I thought about it a long time. I finally decided to take this job.
MRS. CLARK: What was the job initially?
MR. MATHEWS: The job initially? The hospital had had a consultant in the early 1980’s when it began having difficulty with finances. The Federal Government which had initiated the Medicare program essentially just gave a blank check to hospitals and doctors, and by early 1980’s realized that blank check was getting out of control, so they began putting controls on how hospitals could use Federal Government money for services. The hospitals in the early '80’s began experiencing some financial difficulties making ends meet, because of the payment restrictions that the government began putting on them, primarily in the admission and treatment of the government -sponsored Medicare and Medicaid patients. The hospital here had been doing pretty well but began having some financial difficulties. They called in a consultant who made several recommendations to the hospital. They determined that they could either be a large Harriman type hospital or a country type hospital because of the area that it served, primarily the Oak Ridge area and the surrounding counties up towards Kentucky, or it could become a small University of Tennessee hospital. To be a University of Tennessee hospital would mean developing a physician referral system, and begin trying to put in specialty services that would keep Oak Ridge patients and the patients of surrounding areas coming to physicians here in Oak Ridge and using this hospital, if they needed hospital services, instead of going to Knoxville and UT. The management decided they would rather be a small UT instead of a large Harriman. I came in at the end of that. Ralph Lillard had simply been the operating officer of the hospital until that time, and he wanted someone to come in and take that job, while he, Marshall Whisnant, Rick Stooksbury, and others began working to develop this new hospital system. That is when the Methodist Hospital system came into being.
MRS. CLARK: Oh, it did, in the '80’s.
MR. MATHEWS: That is when I came in as a part of that development. Betty Cantwell [Nursing Administrator] and I pretty much ran the internal operation. The We Care Program, I know you mentioned that, had been adopted earlier. Betty had a lot to do with that.
MRS. CLARK: I think she is going to be interviewed.
MR. MATHEWS: Is she going to be interviewed? Good. Betty was very much a key promoter of that, focusing on taking care of… first of all, the employees who worked here, making sure they were trained and motivated, willing to use their skills on the patients at hand, and then with the idea if we did that they would take good care of patients, and we would develop a reputation for patients to want to come here and have their services. That is sort of what we were to do. I came at the end of November 1985, had my first meeting with the board and with people here, and that is what we did. She and I did that working together for several years until she retired.
MRS. CLARK: How long were you administrator?
MR. MATHEWS: I had several positions. I actually came in with the title as administrator because they wanted me to be seen as the operating officer of the hospital. Actually, I was assistant to Ralph Lillard who was assistant to Marshall Whisnant, who had a real structure of hierarchy here at that time. I did not actually become the Chief Executive Officer of the hospital until after the merger with the Fort Sanders System, to create the Covenant Health System. That was in 1996, I believe, when the merger occurred. For a year I was still in as assistant to Ralph, but when they set up the corporate headquarters in Knoxville, I became the Chief Operating Officer of the Hospital services.
MRS. CLARK: When was that?
MR. MATHEWS: It was 1996 or 1997; 1997 probably.
MRS. CLARK: Ok and how much longer were you here?
MR. MATHEWS: Well, I stayed until September 1998, and at that time they wanted, the system wanted, to develop a corporate compliance program for the whole system. They asked me to do that, to move to Knoxville to do that. They replaced me with Dan Bonk, who was a young administrator working in the system, and Dan became the Chief Executive Officer here. I set that program up and worked with the Integrity and Compliance Office for Covenant Health for about 18 months, setting up the program and getting it started. About that time Dan decided to leave and go back to Milwaukee, Wisconsin. There was some turmoil going on here with the union and the physicians at that time, and so Covenant asked me if I would be willing to come back, until they decided what to do as far as Chief Executive Officer. I did that for 2 more years. I guess I was here from April 1999 until I retired in 2002.
MRS. CLARK: So your total time here was . . .
MR. MATHEWS: About 17, 18 years.
MRS. CLARK: You liked the area well enough to stay.
MR. MATHEWS: Oh, yes. Of course we live now in the Knoxville area, the East Tennessee area since 1973, 35 years.
MRS. CLARK: So you didn’t go back to Virginia?
MR. MATHEWS: Not yet.
MRS. CLARK: Who were some of the doctors and Chiefs of Staff while you were here?
MR. MATHEWS: The Chief of Staff changes every couple of years….but I’ll try to remember who the Chief of Staff was the year I came, and frankly I’m having trouble remembering who that was. Doctor McMahon became Chief of Staff later on. Gene Caldwell was Chief of Staff. I worked with so many of them because they serve as Chief of Staff for a couple years on rotation.
MRS. CLARK: Are there any doctor stories that you could share?
MR. MATHEWS: Well we had (laughter) in fact, not too long after I came the hospital was having difficulty with parking. Parking was always a problem and we decided that, I think I inherited this; we decided that we would tow cars parked illegally in the physician’s parking lot. About the time I came, or not too long afterwards, security actually towed Dr. Larry Dry’s car. He and his staff took up too many parking spaces. Dr. Dry was a member of the medical staff, a surgeon here at that time, and we towed his car in. That really created an uproar! (Laughter). He later actually filed a lawsuit against the hospital, essentially included all the officers and the company for that activity.
MRS. CLARK: How was it resolved?
MR. MATHEWS: It eventually was resolved in a compromised settlement. We never towed anyone else but did retain the parking restrictions.
MRS. CLARK: And Dr. Dry?
MR. MATHEWS: He actually went to school and got a law degree during this period of time and ceased to practice medicine and now practices medical law. In fact, I think he still has an office in this area. That is one story I remember. Actually, this medical staff was a very well trained group of doctors. At one time we probably had more Board certified specialists here percentage -wise for the size of the medical staff, than the hospitals in Knoxville. The recruiting efforts to build this medical staff for referral services actually was attractive and pulled in some very well qualified, trained and credentialed physicians into the area. There was not a great deal of controversy over the medical staff. Certainly there were disagreements and that sort of thing, but usually the emphasis on the We Care Program, the emphasis on really putting patients first, providing the best service, ran through the medical staff too. They supported and helped in those programs and efforts the hospital put together to try to do that.
MRS. CLARK: You must have had some influence on getting well qualified physicians.
MR. MATHEWS: I would like to say that, but not in the early years so much. Physicians would come in to look the place over. I usually would meet with them, show them around, and talk about the hospital services; they were always interested in procuring new tools we would furnish for them to help them attract patients. I spent time there with them, but the recruiting was mostly done by Ralph Lillard during those early years. Toward the end of my time here, particularly after we merged with Covenant, I did get more directly involved with recruiting physicians. Our emphasis then was on continuing to fill the primary care base, family practioners in the outlying areas and Oak Ridge. We worked hard trying to keep orthopedic surgery/ surgeons here, helped bring some of them in, and cardiologists, particularly those two specialties.
MRS. CLARK: Both of which are still strong.
MR. MATHEWS: Yes.
MRS. CLARK: You started a good foundation.
MR. MATHEWS: Yes.
MRS. CLARK: You don’t recall anything else particularly in relation to the medical staff or the nursing staff? Any other problems?
MR. MATHEWS: I guess, with the pressure that was put on by the third party payers, particularly in the government programs to be able to demonstrate that you had high quality service; they began to ask for information about mortality and morbidity. The payers wanted to see evidence that we were not doing things to cause people to die prematurely or leave the hospital in worst condition than they were when they came in. That regulation was tied into the reimbursement from the governmental programs initially and eventually taken up by the private insurance carriers. We had to develop a statistical system that measured the results of our efforts. There was some resistance on the part of the medical staff to put that in place because it called for someone looking over their shoulders. The way we developed it obviously concerned the physicians, so it was important to involve the organized medical staff in developing and implementing it. They certainly agreed they would rather have that done than have some third party do it. One of the initial efforts was to go with an organization called “MedisGroup”; they had the early use of computers. Taking all the information we got out of a patient’s medical records and financial records and dumping it into a computer system, you could then pull data out and know the trends. Checking the financial trends was the biggest use of it. They also looked at the statistical trends of patient outcomes, at least what the outcomes were in the hospital. There was no way to measure what happened after they left here. The Federal government did eventually try to develop information to do that which would give us scorecards to show how we looked compared to others across the country. The doctors really didn’t like that very much, but they did participate in it and helped us do the data gathering and looked at the reports. Based on analysis of the reports we would take some action to correct places where it looked like we may not be doing as good a job as we could. That was aimed primarily at group performance, although obviously you got into some individual performance, and that is where it became touchier than anything else: questioning a doctor’s individual practice, how he is treating his patients, and his relationship with his peers. That was an area where interaction with the medical staff was for the most part positive. Sometimes, we had to take disciplinary action or threaten disciplinary action in some way to change the way of practice, but not often.
MRS. CLARK: It seems to me as though you had to solve many problems, George, with government regulations coming about that time.
MR. MATHEWS: It went from absolutely being in control of the physicians signing an order to have everyone second-guessing and looking at what he was doing, and in some ways restricting what he was doing. When I went to Covenant Health as the Compliance officer in 1998, one of the interesting statistics I ran into was that there were over 130,000 pages of regulations that applied to hospital and physician services. We supposedly had to be in compliance with it all. If not, you would be penalized and not be paid or actually be fined and threatened with losing your practice or even be imprisoned. I never was involved with anyone who actually went to prison, but I was involved with threats of fines and loss of payments. These were some of the big changes that occurred during this period of time at Oak Ridge. One of the better things that happened as a result of the pressure was the development of CareTrax.
MRS. CLARK: Of what?
MR. MATHEWS: CareTrax. This was a continuation of the “We Care” idea, but we began organizing it into what was the best practice that we could use as far as hospital services and physicians' practices in the care of patients with similar diagnosis. One of the restrictions that the government put in early in the 1980's and affected the development before I came here was changing what they would pay for Medicare. It used to be they just paid us “cost plus”. Whatever we billed was “cost plus”. It was audited every year, and we wound up maybe two years after the close of the fiscal year knowing exactly what the government's final payment was. In 1982 they went to paying what they called the “Prospective Payment System” where they developed a payment system based on Diagnostic Related Groups. There were twelve of them. They covered the various medical and basic services that were rendered for patients who had similar diagnoses, and they would pay us retrospectively. We knew whenever one of those patients was admitted what our case rate was going to be for that admission. Certain exceptions were made if someone had a bunch of complications that required more than the usual services. We had to be sure that services covered what the patient needed but no more, because you were only going to get a certain payment. That went on for a while, and finally we came up with and developed CareTrax for certain high resource use diagnosis. We worked with the doctors to develop the system, the things that needed to be done on day 1, day 2, etc, to be certain this patient made progress toward recovery and discharge within a reasonable period of time. Two reasons to do this: one, hopefully, it would be better for the patient, and secondly, it would be better for the payment. It would help us stay within what we would be paid for the patient’s care. This hospital did a really great job working with medical staff. One of the Chiefs of Staff, Dr. Randy Reid, ophthalmologist, helped tremendously, and I think it was during his tenure as Chief of Staff that we really concentrated on that type of managed patient care. He got the medical staff organized to promote this kind of service. He became a consultant with the Horty, Springer consulting firm out of Pittsburgh, Pennsylvania. They put on training programs for hospital medical staff members, teaching how to be a staff officer, and leader, the business aspects of the medical staff, how to deal with physicians who didn’t want to go along with the best way to do things. They actually put on seminars all across the country on medical staff organization. Randy still teaches these seminars.
MRS. CLARK: Well, you saw a lot of changes during your service here.
MR. MATHEWS: Oh yes, when I sometimes think of the changes that occurred in hospital service and medical practices from the time I graduated from college until I retired, it is mind boggling.
MRS. CLARK: You are not sure you would go into the profession now.
MR. MATHEWS: Knowing a little about some of the things going on right now, I would want to take a close look. No, I would still choose the work as I felt good basically about what we did. In college, the graduate school finance course was taught at the University of Richmond rather than Medical College. They essentially told us we are going to teach you all this stuff in corporate finance, some of which I had in college, but your biggest job will be getting the Board to find ways to make up the deficit each year or finding other ways to fund the deficit. That’s what they told us. Then, when I got to the first hospital I worked in, it certainly did not operate that way. They had a big fund- raising program to raise the bottom line or for construction during the time I was there and had a charity program that was funded out of donated funds from the Baptist Church Associations in North Florida. Twenty-one associations worked with them. The hospital had a sound business operation. We had a budget, we had a financial statement, we worried about accounts receivables and the bottom line, even though they told me in college I would not be dealing with that stuff. The hospital administrator this day and time has to pay attention to the business, and it takes up most of his time. At the end of my career that was where I was, and I hated that part of it. I was not all that happy with it, I liked the idea of getting out around where the work was going on, talking with employees, and doctors and seeing what was happening, trying to fix problems they were having doing their jobs. Towards the end, and probably now, I image Mr. Belbeck does not get much chance to get out and do some of things that I did early on. The change was not one that I liked very much, but it was one obviously necessary to do it in order to keep the hospital viable.
MRS. CLARK: Your clerical staff must have really exploded during this time with all the regulations.
MR. MATHEWS: Yes, well of course. When I was in Florida the first few years down there, there were three or four of us on the administrative staff and 12 managers for the hospital and we had a 500 bed hospital. Today there are probably 25 to 30 people doing the same work, well, not the same work but having some of the same responsibilities we had. For instance, I was risk manager /safety and security officer and handled a lot of the non-nursing department responsibilities and that sort of thing. The hospital now has a full-time risk manager.
MRS. CLARK: What was the physical plant like at that time?
MR. MATHEWS: Here, well the hospital had just finished adding the… remember the old lobby had just been rebuilt. They had added two tower floors on the west wing, and Physicians Plaza. They had just gone through a big expansion and renovation program during the early 1980’s, so they had just come out of expanding the hospital.
MRS. CLARK: You mentioned beds before, so about how many beds were here?
MR. MATHEWS: They had had the same number of licensed bed capacity since I first came here: 300, 301 or 302 beds are licensed now. The number being used diminished over the years. We were at an average census of around 150 patients a day, and when I left we were creeping down to 100. I don’t know what it is now. But that is a result of all the emphasis on doing things for patients outside the hospital. After War World II, 1950 – 1960’s the emphasis was on doing it in the hospital; the doctor wanted the patient in the hospital no matter what it was, he wanted the services there and the recovery there. Cataract patients used to stay nine days in the hospital. Now you go in as an outpatient, get it done in the morning, and go play golf in the afternoon, I guess. So the demand was to build more hospitals and Medicare, when it came in 1960’s, just fed the demand for more beds and services. What it did was provide a huge amount of money to expand that system, and that is what happened. Finally the government realized they were expanding a system that was going to eat them alive. So that is when the restrictions started and also at the same time medical science and improved practice made it possible for people to be treated on an outpatient basis, in a doctor’s office or in some kind of organized outpatient program that previously was performed in a hospital room. So we had those changes going on. The less intensive patients were leaving the hospital for outpatient services. During the period of time I was here, and just after the hospital had expanded, we had to build facilities to try to accommodate taking them out of the hospital, like the Cheyenne Surgery Center, the outpatient department over there, the Cancer Center, all those things. That happened and was going on and that reduced the demand for numbers of patients to fill those beds and at the same time there was an emphasis on managed care. I mentioned a while ago…the CareTrax actually reducing the amount of time the patient stayed in the hospital. The open heart surgery patients, for instance, I remember when we first started doing that at Baptist in late 1970’s early 1980’s, generally had an average stay of 15 to 16 days and now it is 4 days. I think something like that if they stay that long.
MRS. CLARK: Where you ever a patient?
MR. MATHEWS: Not while I was the administrator. I have been a patient here since I retired for a couple of days.
MRS. CLARK: How was your care?
MR. MATHEWS: It was fine; they took good care of me. They did all the work-up outside. It used to be they admitted you, did the work -up, then did the surgery, and you stayed here 4 to 5 days. But as it turned out now they did all the work-up before I came in for surgery. I was here 3 days, (I think) then I recovered at home.
MRS. CLARK: I have not mentioned the board. What where your relations with the board?
MR. MATHEWS: Of course, I worked with the board. George Jasny was Board Chairman when I came and George was chairman for a while. Percy Brewington became the chairman after George. I don’t remember when Bill Manly came on the board. One thing that Bill Manly did when he came on the board, he brought his corporate executive experience that he had developed at Carbide and Cabot Corporation, and he insisted on us really tightening up our financial plan. We did that in the early 1990’s and it was really helpful to us. In fact, he helped the hospital weather some pretty severe storms, and if we had not done some of the things he urged us to do, really insisted we do, in the way of building reserves, really looking at the management of our finances, the hospital would probably have been in a lot of trouble in these last years when the reimbursement from payers became less than the cost of providing the services in many cases. If he had not insisted we build up our reserves for a rainy day, the hospital would be in more trouble than it is now. I am sure his counsel is still valuable to the hospital today. It does not sound like it is getting any easier. The latest thing the federal government has done is try to reduce its cost under the umbrella emphasis of better service which continues the pressure on boards and management. Used to be we just took it for granted that some hospitalized patient was going to get an infection. In fact, my thesis in graduate school was on what the Administrator's role might be in the prevention and treatment of hospital acquired infections. Now if a patient, a Medicare patient, gets a hospital acquired infection, it is my understanding that this year or next year, if you can’t prove that something other than hospital technique caused that patient to get an infection, the hospital won’t be paid for it. They will treat the patient but will not be paid for it. As I read the information on it, there are several diagnoses if it looks like something the hospital could have controlled events to prevent what happened, then the program will not pay for the services.
MRS. CLARK: Do you think that might help prevent more infection?
MR. MATHEWS: It all comes out of a study that was done in the late 1990’s that says that you know that hospitals could prevent something like 90,000 premature deaths in a year, if they concentrated on trying to provide a safer service. There is no question that this change in payment is designed to change the mindset that a patient comes in and will probably get an infection. When the patient comes in, we have to prevent them from getting the infection; yes, certainly, that would be better care for the patients.
MRS. CLARK: It wasn’t as much of a problem when you were here?
MR. MATHEWS: Well no. Infection has probably been the post-operative infection and other types of lung infections and things like you can get by just being in the population in a hospital. It has always been a real bug-a-boo. We always thought we were doing our best by cleaning and disinfecting with soaps and sanitizers. Not just washing your hands, but scrubbing them and using antibacterial solutions and things like that so we thought we were doing what we needed to do. But this moves infection control to a whole new level. It would be best to try and prevent it, but if a patient gets it, try to keep it from spreading. Preventing it from happening puts a whole new focus on it than we had faced even though we were concerned about it, cared about it and did not want it to happen, during my entire time as an administrator.
MRS. CLARK: I understand with so many elderly patients coming out of nursing homes to the hospital that they are bringing infection with them.
MR. MATHEWS: The methicillin-resistant Staphylococcus Aurous, which is an infection that we all have on our skin surface and nasal surfaces, and sometimes if you get really sick, it will overpower you if you get the infection. That is what I did my thesis on. Back in the 1960’s, there was an outbreak of this in babies in the newborn nurseries where they began clustering all the babies in one nursery. It became a real problem with it at that time. I picked that up as a thesis to work on with a professor in microbiology as my advisor at the Medical College of Virginia.
MRS. CLARK: Were the results ever published?
No, just my brown copies that I have somewhere in my stuff. They were in the Medical College Library, of course, but I don’t know if they ever did much with it.
MRS. CLARK: Where there any major disappointments that you faced while you were here?
MR. MATHEWS: While I was here, I guess, I don’t know if you call it major or not. I guess the struggle we had over the years from time to time with the union which represented employees here was a source of disappointment. There were times when I thought they didn’t help us with the employees, getting them to see that the hospital was just really not able to do some of the things they wanted, feeling we should do more.
MRS. CLARK: You didn’t face a strike?
MR. MATHEWS: Yes. We …. No one wanted a strike here. In fact Betty Cantwell and I negotiated the first contract in 1986 when the nurses were then represented by Tennessee Nurses Association which switched to the Service Employees International and became an industrial union. There were two bargaining units: one representing the registered nurses and the other all eligible employees. We negotiated two contracts in 1986, and then it was about every three years when we negotiated two new ones the whole time I was here. And all those had their ups and downs; sometimes it was harmonious trying to handle the right problem; sometimes it really got contentious, and the last one with another third party in the picture really came close to a strike. We came so close to having a strike in 1999, the year I came back. We were within two or three hours of a strike. I think everyone blinked when they saw how contentious it was and saw we meant business, that we would not cave in. We gave one little concession, and they took it and avoided a strike. We had made preparations. We actually had contracts with traveling nurses’ companies to bring nurses in to keep the place covered, and we had plans in place to move patients to Knoxville. So it came that close. Since that time I gather they have been able to go back to the type of bargaining that does not raise the temperature to that level. Maybe that particular time scared everybody.
MRS. CLARK: Oh, my goodness…that was a really major problem.
MR. MATHEWS: That was the most contentious one. You ask about disappointment. I guess a major disappointment was realizing organized groups of people are going to look out for their own self-interests, and that may not be best for the hospital.
MRS. CLARK: I don’t know whether we have covered everything, Is there anything you can think of we have not covered?
MR. MATHEWS: One of the great things that happened while I was here, was Marshall Whisnant’s insistence we…. to start with he read a lot. He read Dr. Demings Quality Improvement program to produce better results. The theory was the managers of an organization owned the systems and they need to really work on those to make sure they were working properly so that the people who were doing the actual work could achieve constantly improving results. Marshall insisted we develop something like here. We signed a contract with QualPro down on the Pellissippi Parkway. We went into the training with QualPro; we trained a lot of managers on using statistical measurements to solve problems and to improve operating procedures and to focus on fixing systems, so that people who were doing the work could achieve good results. We focused on taking variation out of processes. For example, the process was used to develop the CareTrax program I mentioned earlier. It finally became a real thing across the country, to try quality improvement in an industry or business to compete nationally and internationally. Anyway the state of Tennessee developed a Quality Award to do the same thing with businesses in the state, and they offered four levels of awards to organizations that could be surveyed, inspected and present data that showed that they were meeting certain levels of quality achievement in their organizational operations. We finally applied for (again at Marshall’s insistence) one of those awards. Lo and behold, we won the first year we tried…we got the quality achievement awards which were the second or third level; I can’t remember the four levels, and we did that for two or three years. Finally in 1997 or 1998 we actually hit the jackpot….we were the first hospital to win the Governor’s Quality Award, which is the highest level you can get in the fourth level for a hospital. Now since that time the hospital has gone after other kinds of recognition, where they demonstrate a certain level of quality service to national organizations. They have won several like that since that time. But that was the most significant thing that happened while I was here, to get that Governor’s Quality Award. It was really great. You wanted me to bring pictures….actually one of the pictures I had were of us in Nashville getting that award, three of us on the stage getting the award.
MRS. CLARK: Bring them by sometime and let Quincy scan them.
MR. MATHEWS: For going over there and getting that award we took quite a number of employees with us and it was really a good feeling to get that award.
MRS. CLARK: Now your title was Chief Administrator?
MR. MATHEWS: The last title after Covenant Health took over. We got to looking at the titles, what we were going to call people, such as the President and Chief Executive Officer of Covenant Health and so the President and Executive Vice President were there. So what do you call the administrators of the hospitals who essentially report to one of these operating officers at Covenant Health? So we came up with the title of President and Chief Administrative Officer in each of the entities. So that was my title when I retired.
MRS. CLARK: What was Marshall Whisnant when you were working here with him?
MR. MATHEWS: He was president. Under the old health system that was developed when I came, Marshall was the president, and he remained that until he retired. Then Ralph Lillard became the president for a short period of time before we actually merged with Fort Sanders Alliance. When that merger occurred, I became the Executive Vice President to Ralph and then after the merger we started looking at titles for the whole organization here and Fort Sanders Hospitals.
MRS. CLARK: I certainly do thank you, George. I think you have shared a lot of information for the archives on how the hospital was operating during your time here. If you do have pictures….
MR. MATHEWS: Yes, I absolutely forgot that you suggested I bring… I did look and I did find a few things. Of course the public relations here have probably more than I have. It’s hard to remember it all. One of the highlights I did like was playing Santa Claus.
MRS. CLARK: You played Santa Claus?
MR. MATHEWS: Yes, Marshall started it out and I shared it at Christmas on Employees' Day. It was and is called “Turkey Day.”
MRS. CLARK: How many pillows did you have to stuff yourself with? I would like to have come to a party then.
MR. MATHEWS: That was sort of a highlight….to play Santa Claus. All of the employees' kids came around and some of the big kids wanted to sit on Santa’s lap and get a picture taken.
[End of Interview]
METHODIST MEDICAL CENTER ORAL HISTORY:
DAVID MCCOY
Interviewed by Quincey Harrington
September 3, 2008
MRS. HARRINGTON: David, tell about how you first came to Oak Ridge?
MR. MCCOY: I came to Oak Ridge after my mother and her husband moved here, a year and a half later in 1951. I lived with my mother and step-father in Lexington, Kentucky, and was talked into coming to Oak Ridge to finish up at Oak Ridge High School. Which was a good thing, I’m glad I did. I had a great time at Oak Ridge High School and I am so glad to see its growing also, like the hospital is growing now. It makes the city look a lot better but I have to say I miss the long halls of the Oak Ridge Hospital before it was Methodist. There is a lot of history that a lot of people nowadays don’t realize what doctors and nurses all went through before this building was built.
MRS. HARRINGTON: Tell us what you know about that.
MR. MCCOY: I do know that they were limited in a lot of areas. A lot of doctors did not have equipment to do the things they needed to do. Many of the patients were sent to Knoxville. Now, Knoxvillians are coming here. I think that is very good.
MRS. HARRINGTON: What do remember of the hospital as a teenager?
MR. MCCOY: It didn’t’ look like a hospital really. They looked like barracks and I guess if you lived back in that area, I was just after the muddy streets and wooden sidewalks so I didn’t get to see all that. But I fell totally in love with Oak Ridge, the way it was right then and as things begin to grow, you sort of look back nostalgically, “Boy, wish it was still that way” but as things change like this beautiful building that everyone is enjoying throughout the community, it’s worth doing. The hospital is one of the key things in any community. I am very proud to have worked here.
MRS. HARRINGTON: Were you ever a patient here?
MR. MCCOY: Oh yes, a couple of times. I injured my knee in a very freak accident and I had a leg operation not long after that. I believe that is the only two times I have been in the hospital.
MRS. HARRINGTON: How long were you in each time?
MR. MCCOY: Five days on one and overnight on the other.
MRS. HARRINGTON: When did you come to work at MMC?
MR. MCCOY: I was here about 8 years, so probably 2000. Earlier I was at the Oak Ridger. I returned back to the Oak Ridger from the Courier News. The call went out for a new, Executive Director for the Foundation. I didn’t feel I was qualified, but I was very pleased the search committee finally chose me to come in and take over. That was a great thing for me. It was a different way of life. I had to learn a lot, but had some good teachers and we moved the Board a little forward.
MRS. HARRINGTON: So who brought you on?
MR. MCCOY: The search committee consisted of Lou Dunlap, Martha Hobson who was the outgoing chair, and the incoming chair for the foundation, and I think I was interviewed twice. You walk away from the interview thinking “I wish I had said this, I wish I’d said that” but whatever it was, it worked.
MRS. HARRINGTON: Who was the CEO at the time?
MR. MCCOY: George Mathews was the CEO and then came Jan McNally. She and Randy, I think, were the two that recommended me for the position.
MRS. HARRINGTON: Who did you follow?
MR. MCCOY: Glen Landy, Glen was director for a number of years here and moved to Oregon? He went to work in a similar position in a different environment of course. I replaced him.
MRS. HARRINGTON: What do you know about the history of the foundation, when it started? Do you know any of that information?
MR. MCCOY: I think the idea was generated, Herman Postma was one and it seems like George Jasny, both are deceased now. Ken Sommerfeld was also a founder. They were very instrumental in working on getting the foundation started. It was an independent foundation at the time, run by the Board, controlled by the Board, the Foundation Board. It was sort of separate from the hospital. I did serve, now that you mention it, on the governing body of the Board of Directors back in the 1980s, I believe it was when Methodist was just Methodist and it was controlled and run by a governing Board of Directors. I represented the county, because I was the publisher of the Courier News. Bill Manly, who was a big supporter of the foundation, was one of the guys that was involved in the beginning, come to think of it. There is a tremendous amount of effort and money put into the foundation. We even named the hospitality house after the Manlys. He built and paid for the Quiet Room in the hospital. His wife was critically ill and finally died. The Quiet Room is a resting place, they put him there, it had gray walls, gray furniture, gray floor and gray everything then he couldn’t stand it. So he went home and got his wife’s favorite painting and brought it down and hung it on the wall and he and Jenny Edgar went on and bought new furniture and everything to match that picture. He paid for it and left a grant, in an endowment of enough money. He left an endowment for that particular room alone, so that every five years, we are to upgrade it, repair anything, and we need to honor that. He gave a tremendous amount of money to the Wellness Place and the Hospitality House. We are very grateful for a donor of that magnitude. I guess probably Bill is still the leading donor in the foundation.
MRS. HARRINGTON: Was he on the Board?
MR. MCCOY: He was going off the Board I believe when I was coming in but he was, prior to that, Chairman of the Board of the hospital.
MRS. HARRINGTON: Who else was on the Board when you came?
MR. MCCOY: I think Ralph Aurin, Ken Sommerfeld, Wanda Craven, and Pat Coffey.
MRS. HARRINGTON: Who were the physicians at that time?
MR. MCCOY: It was Dr. Richard Dew. He recommended Dr. Stanley to replace him when he retired. Stanley has been a very supporting character, I guess you would say.
MRS. HARRINGTON: When you came on, what was the main focus of the foundation? What was your main drive? Which program did you support? Goals?
MR. MCCOY: Well, my goals were to listen to George Mathews. George was CEO when I came on and after he left, Jan took over, so the first day I was here, I was asked to meet with George in the cafeteria for breakfast at 7 o’clock and I was here until 5 p.m. I was eager and excited about being chosen. I really admired George Mathews highly and he proceeded to explain to me, he had an open door policy. He was thrilled I was on board, “Don’t let anything fester. If you have a problem you can’t control and solve, you come and see me and together we will do it.” And boy, it was a beautiful arrangement. He gave me two goals. The first goal was re-institute the golf tournament because his philosophy was that the doctors worked together and sometimes they need to play together and that was a real challenge to me. I thought I can make this happen. I never even worked in one except with the heart fund with Carol Smallridge.
MRS. HARRINGTON: What happened with the golf tournament before?
MR. MCCOY: It died for about 2 or 3 years, it just went away and Bill Fort who was my co-sponsor here and I went to interview a couple of the past chairs who challenged us and said we would never make it happen. Well, as we walked out the restaurant, Bill and I shook hands and decided we’d just received our supreme challenge, let’s go for it. Seven years in a row, when I was here, we did it. We made money every time. Not a whole lot, but I think we made $16,000 to $18,000 a tournament. The main thing was, about 45 golfers of the 85 golfers were doctors of this hospital or surrounding area. The first year we had a little problem because the guys wanted to talk as much as they wanted to play and we had to be the rangers, I’d guess you’d say. “Guys, tee off, it’s your time, and you’re backing up.” The other challenge was George felt that we should have a second hospitality house, and the house next door to the present house was deteriorating. I took a lot of pictures. A lot of the departments did a lot of storing of equipment in it. The floors were sagging.
MRS. HARRINGTON: It was owned by the hospital?
MR. MCCOY: It was owned by the hospital. Prior to that, it was owned by Jim McMahon, pharmacist in Jackson Square who had leased it out to Emory Valley Center. Then it was one of the group homes. I think they outgrew it or something but they left it and it was just dying away. I brought Lou Rabinowitz on board. He was a member of our Board of Directors. He had a tremendous amount of influence with the Knoxville trade and labor council and there were 16 or 17 different trades that put their spare time and money into the townhouse.
MRS. HARRINGTON: CALM stands for?
MR. MCCOY: Collaborative Agreement between Labor and Management.
MRS. HARRINGTON: Who does this involve, management?
MR. MCCOY: The trade unions, like at the plants. They have certain groups that are non- union, but they work with the union and they work together on different projects. It brought them together. It was really wonderful. They took a lot longer and Lou and I got a lot of criticism for it taking so long but my philosophy was you couldn’t look a gift horse in the mouth and a hundred years from now, it’s not going to matter because that building will still be standing.
MRS. HARRINGTON: Who were the key players in CALM?
MR. MCCOY: Key players were Mel Schuster, Ray and David Garcia, electrical. Ray was the president of the painters union. Schuster was over all. I think he and Ray took turns in being in charge of CALM. It was a group all to itself. It had its own bank account. The way that it worked is every laborer at the plant, so many pennies for every hour they worked went to them and they built money up. They put it all into the common house. I have never been prouder than anything. Every time I pass that, I think there is the fact that our celebration, if you remember, I called George personally and said he needs to be there on Sunday, October 22. He said “Why?” Because I just fulfilled my agreement with you.
MRS. HARRINGTON: When did you start on the CALM house?
MR. MCCOY: Four years and running so about 2004.
MRS. HARRINGTON: How did you raise money to do that?
MR. MCCOY: Door to door a lot. We raised enough money and had enough help; I didn’t gather all the money myself. I did some of it but we funded the entire house. Then I was tying my tie one morning and getting ready to come to the office and the news came on and said this lawyer of Knoxville, Gordan Sams, was requesting non-profits to come after amount of money for the national vitamin settlement that four vitamin companies had conspired together and fixed prices on certain vitamins and they got caught at it and it ended up into millions of dollars. I think the Knoxville area or East Tennessee got something like $220,000 dollars. They said there is no official form, just sit down and bleed your heart and send it to Mr. Sams. Well, I put in that I needed $125,000 for the CALM house, explained that and I’ll never forget that weekend. I spent the whole weekend in my office. It was like pulling paper. I don’t like this, I’d throw it away and I’d start over. I became good at hitting the wastebasket. Finally, I decided that I needed $150,000 for the Wellness Place which was also under the wing of the foundation but my goal was to get a van and equipment to get out into the rural communities to people who had no formal medication, tests or anything. I was going around trying to get volunteers, the dentists, some nurses, and different people. I was doing okay in that area, but I lost out on the $150,000. Well, the state, attorney general’s office vetoed $150,000 said I could do that myself but they gave me $37,500 for the CALM house and said I had to complete the project with that amount of money and could not get any more from anybody but it had to be a one time deal. “Whoa!” So I tore it up and then I decided “You know, such a dumb thing”, so I sat down and wrote a letter and took it to the attorney general’s office and said that my project needs a lot more than $37,500, I forget what it was and I could certainly use that $37,500 inside but it was going to have funding also from individuals and I didn’t think it was fair to be reprimanded for something that was not going to work with that amount of money. Two days later I got a phone call from the attorney general’s office staff. She said “McCoy, they voted yesterday to allow you to get that money and they will see you in Nashville next week on Wednesday” so I tore to Nashville and sat in a crowd of a bunch of people. Seventy different non-profits from Bristol to Nashville, I think received that money and we got $37,500. That really set me going. Then we had some individuals including a board member to fulfill an obligation by the funding of different apartments and that is the way that we did it like Leadership Oak Ridge. I was very proud because I was in the class of 2004 and every time Carol Smallridge would hand me the microphone on the bus or in the restaurants or wherever we were, I’d say I was the go-to guy with microphone to get things started and I always included the new apartment we hadn’t named at the time. I was telling people we needed money for this. Well, Mary Yoder, who was in Leadership Oak Ridge, who was also on the MMC Foundation Board of Directors and I were named, she was named Chair and I was named Vice Chair of the fundraiser that each class has to do. They had to vote on what projects they wanted and there were 3 or 4 hanging out there and I had my fingers crossed. They voted to do the fundraiser to support and pay for one of the apartments in the CALM House. That was wonderful. We worked our little fannies off and started the Casino night and that is how that got started. We needed $10,000 and when all the smoke cleared, dust settled and the pennies stopped rolling, we had $10,400. We bought the plaque and gave the $10,000 to the CALM house. We accomplished our mission.
MRS. HARRINGTON: Thus, began one of our annual events as well?
MR. MCCOY: The other annual event I am proud of is the golf tournament. I wish I had renamed it the Phoenix because it was like bringing it back from the ashes.
MRS. HARRINGTON: What did you support in the Wellness Place?
MR. MCCOY: We supported mostly the senior movement. Lynn Burchell was in charge of the Wellness Place and she had a fantastic senior citizen thing going operating at the mall. There was a room in the mall people donated to, and Lynn did a great job of heart checks, blood checks, all this kind of stuff, and exercise around the mall. It was a winner. Then it moved over to the Wellness Place, and she moved with it and kept it going for quite a while and we supported it. Bill Manly was a tremendous supporter of that and gave thousands of dollars for an endowment to keep the Wellness Place going. One quick story about Bill Manly. He was one of the most generous men, he taught me so much. I wished I could live like he lived but I don’t have the bucks. I admired the way he did it. Barbara and I had dinner with him every Monday night for 2-1/2 years at the Bluehound in Oak Ridge. He had a different group of people he met with. He ate there every night of the week, except the weekends. We don’t know what he did on the weekends. Lynn Burchell, director of the Wellness Place, told me she needed a bone density machine and so I had received a $500 check from someone and I put it on it and I said how much do you need? I need $10,000. So I wrote a letter to all the board members, sent it out, two days later, Bill Manly called me. “Why didn’t you talk to me about the bone density machine?” I said, “Are you upset about it?” He said no. He said, “You didn’t need to go to that trouble.” I said, “Oh really.” He said watch your mail. Two days later, I got a check for $10,000 for the bone density machine. That is a lesson in life. Isn’t that great? He was that way all the time.
MRS. HARRINGTON: When did he pass on?
MR. MCCOY: He was 80-years old and I he’s been dead probably three years now. I knew Bill Manly well enough over the three or four years I dealt with him, I would go up and visit him just to get my motor running again and I would take different people like Susan Hand, Jan McNally, just to give him a little attention. I got to be very close with his sister Sonya and her husband who lived in Ohio I noticed he was deteriorating. He was 79 years old and I called Sonya and said “I don’t want to be the bearer of bad news, but your brother is slipping.” She said, “We had felt the same thing. I think it was important that you told us. We need to address that.” They came down and spent a week with him. We went out to dinner and she said, “You’re right.” I said, “I’m telling you one thing right now, he’s waiting for his 80th B-day because he planned a celebration because he made me do it. We rented the entire Bluehound Restaurant for one afternoon/evening, closed it down and filled it with people he hadn’t seen in years and years. It wasn’t long at all until he passed. He was waiting for his 80th B-day. He just turned 80. He saw people he hadn’t seen in years he use to work with. He was a blacksmith-type. He became a very wealthy man; he and another fellow invented something that made him very wealthy. I didn’t know the other guy. When Bill came back to town, he had been here before at the plant and left and then came back.
MRS. HARRINGTON: You dedicated the CALM House on October 22, 2006? Is there is anything that stands out? You did the Golf tournament, CALM House and supported the Wellness Place. Were there any other programs?
MR. MCCOY: We did a lot with that. We collected enough money and supported the Chaplains fund, We Care and we sort of took charge the We Care. I can’t say we took charge but we were very involved and we had a different chairman every year. The one person who stands out the most is Lois Layne. Lois was a wiz in putting together the We Care and every year they exceeded the previous year. When I think back, it really wasn’t work; it was a way of life. But it was a way of life; it was not a job at all. I think I miss that the most, but now I’m doing pretty good at what I’m doing. I always felt like when I went to the foundation, it was like giving a little back to Oak Ridge because I watched so many people, so many years in my position at the Oak Ridger and as they passed on, it just made it necessary to keep the candle lit, I guess you could say. I always felt good about anything we might have accomplished because I knew it was helping somebody and the robot. Talking about the robot, that was a challenge. The corporate office gave a tremendous amount of help but they had never seen a project go that well in that few of months and that was a good thing. The city of Oak Ridge and surrounding areas was really recognizing MMC as a major player. You got to convince these people that you are who you say you are or they are not going to open their pocket books. That was a lesson I learned. I took a lot of lessons from Bill Manly. I have to throw in that Herman Postma thought I wasn’t qualified for this position. He said “McCoy, we want you for who you know and who knows you. You bring them to the table and we will feed them.” And that is what we lived with. I learned a little bit about fundraising and what-have-you, about every book I could find. I was allowed to go to two to three different seminars from Pride Philanthropy group which was big. You didn’t really learn that much but it re-ignited you in being a little bit better and different. Made you keep going. It was worth doing.
MRS. HARRINGTON: How much did you raise for the robot?
MR. MCCOY: One million, three-hundred thousand dollars. I was so proud of that. I’d like to make a comment about Bill Nowlin, who was instrumental in putting the robot together from the utility company and reason being that Bill was an Oak Ridge High School graduate, the student of Benita Albert who is in her own way one of the best teachers ever Oak Ridge has had. Together they clicked and I found out Bill was the one, the sales rep kept saying, “I wish Bill were here. He would have loved seeing this.” I said, “Denise, who in the world are you talking about?” She said, Bill Nowlin, our chief engineer, whatever his title was in California, is the one who was instrumental in developing the robot and he is from Oak Ridge. I ran to my phone book and found his parents on Melvin Road? I called them and said we are having a demonstration starting tomorrow I want to invite you & your husband, Charles, to come at 9:30 because it opens at 10 and we just want you to touch your son’s labor. A few minutes later I get a phone call from Mr. Nowlin. Uh oh, what have I said? He said, “We cannot do this without you asking Benita Albert to come over.” So I said “Ok.” It was after four. I never forgot the afternoon. “I got to find this woman.” Called the high school, the secretary said, you know I just saw her and I think she is still in the building. So she rang her room and Benita was cleaning up things to leave, explained to her what I had. She said without hesitation, what time? Where? I’ll be there. They all three came and I brought Pete Craven and David Coffey in with them. Benita came over and asked it is possible for her to send three of her students every hour to come in and play with it and look at it, know the story behind it and it really kind of chokes when you up to see three different kids every hour with a gleam in their eye. They want to see what somebody from our class has done. They did that for two days and never ever got in the way. We found out later she had given each an extra credit for coming. That was a good thing. More fun. That was a highlight.
MRS. HARRINGTON: For the record, the DaVinci robot, in the beginning was mainly for cardiothoracic surgery and neurological surgery? Doctors that were involved?
MR. MCCOY: Dr. Hall, Dr. Sloan, Dr. Stanley. They were the three main players. All three are still here. Dr. Bill Hall stayed on Jan’s back for so many months, that when he finally quit beating the table and she Okayed it, I wondered often what they talked about after that.
MRS. HARRINGTON: How did it come about that was what you were going to raise the money for?
MR. MCCOY: Best I can remember, Bill Hall really did really pursue this, he had to have it, he was going to Knoxville to Fort Sanders to use theirs, Fort Sanders Regional to use theirs and he had to get in line. He never knew when he was going to take a patient. He convinced Jan. Already getting started and then Jeff Elliott came in and sort of orchestrated part of the campaign. He had been a tremendous fundraiser in the past. He was really sharp on it. Taught me quite a few things. I always thought after this one was over, I felt I knew enough to do another one. I retired before that.
MRS. HARRINGTON: Other machinery, technology that the foundation bought for the hospital?
MR. MCCOY: Yes they did need IMRT, which I thought it was an instrument but it’s a program but it cost $500,000 and wrote the Cancer Center a check for $500,000. When a person needs radiation, it used to be if you needed to have radiation on your nose, your whole face got it. With this process if you have a need for radiation on the nose, it zeros in on just the nose. It’s a much safer process, probably faster and easier. I was very proud when the board tossed it around because four or five months before they finally said let’s do it, I heard all different kinds of combinations on how they can make it happen. I always thought you just write a check and you got the money and finally that is what happened. That is the tough part about being a staff member and not on the Board that I really had no say in that one and was hard to get used to because I’d always want to say something. I learned to keep my mouth shut.
MRS. HARRINGTON: Who were your biggest donors of the robot?
MR. MCCOY: Jan, Jeff Elliot and I approached the Board of MMC Volunteers one morning. We went in shaking like a leaf and asked them to make a donation of $300,000 over a 5-year period to be given by the MMC Volunteers through the gift shop, fundraisers they hold, book sales, jewelry sales, whatever, would they possibly consider doing that? We made our pitch for the Surgical Robot. They said would you please leave the room so we went across the hall to my office and I believe Murrell Hughett came in and said the Volunteers Board has voted unanimously to donate the $300,000 for the robot. One, we got the money, two, it showed that people inside the hospital looked forward to it - and we were able to tell that story. Hard to work with sometimes, but overall it was a grand finale.
MRS. HARRINGTON: Final thoughts about the foundation?
MR. MCCOY: Seeing things that I didn’t know could happen. One thing I liked was that more and more people began to know more and more about the MCC Foundation during my tenure. I believe because we raised a lot of donors and made a lot of noise. Before I came I knew not much about the foundation and nobody else did. One thing I am proud of is now people around the community, robots, casino nights, golf tournaments, CALM house, they all know a little more about the foundation and that makes me prouder than anything. The biggest thing is the people I worked with. Not a job, a way of life. I could go to any department, ask for any favors, on any floor and everybody was always willing to give, how can I help you? The managers always had a meeting on Tuesday morning, and I was given ample time anytime I needed to get up and give a spiel, about We Care, about the foundation, CALM house, about anything I wanted to get across. This is just a grand place to work. One thousand-three hundred people involved in this movement are unbelievable. You don’t see that everywhere. MRS. HARRINGTON: Thank you.
MR. MCCOY: Thank you.
[End of Interview]

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Contents
COLETTA MANNING 2
GEORGE MATHEWS 18
DAVID MCCOY 39
METHODIST MEDICAL CENTER ORAL HISTORY:
COLETTA MANNING
Interviewed by William (Bill) J. Wilcox, Jr.
January 7, 2009
MR. WILCOX: This is an interview Bill Wilcox is having with Coletta Manning in her office on the afternoon of January 7, 2009. Coletta, I so much appreciate your agreeing to do this interview with you as part of our MMC book project. How about we start by your telling me a little about how you came to work at the hospital, when that was, what your position was, and perhaps a little bit about your training?
MRS. MANNING: OK. I grew up in Oak Ridge. As I was growing up here my family didn’t use this hospital because this was part of the land that my grandfather lived on, so he was pretty upset with the government for taking his land. When I came to work here he and the rest of the family started using the hospital at Oak Ridge. The first time I came to work here was in 1968, the summer of 1968. My husband at the time was in the Navy and it was the height in the Vietnam War so he was going back and forth to Vietnam. He would go to Vietnam and I would come back home here and work for nine or ten months, and then when he came back to the States for four or five months, we lived in California. I came to the hospital first in 1968, just worked for the summer, and worked as a staff nurse on the old 2 North on the 3 P.M. to 11 P.M. shift. It was the toughest unit in the hospital, no doubt. We had a lot of really, really sick patients. It was a very tough unit to work; it was a medical unit. When I came back to work in 1969, I had a brand new baby and I worked in the old ICU, which was on the third floor back at the end of the hall. It was a five bed unit, I worked 3 P.M. to 11 P.M., full time, and I was in there every night with just one LPN and a lot of prayers because we got every kind of thing you can possibly imagine in there. And we did not have full-time doctors in the Emergency Room, we didn’t have doctors around the clock in the hospital, so whenever we had an emergency or something like the patient going bad, it was really tough trying to find a doctor to get them there to help you. But it was the only way we knew. The next time he went to Vietnam and I came back in, I believe, is when we opened the Coronary Care Unit. It was the first coronary care unit that Methodist had had. I had had special training in coronary care and had opened two other coronary care units in Tennessee. One being in Murfreesboro back in 1966 and another one at the Navy Hospital in Memphis, I helped open that one. So I already had some coronary care training, I loved cardiac care -- that was really my first love. The rest of the staff that was hired for the Coronary Care Unit had not had that training so they went away for the training and I was working in the ICU while they went away. I think I am the last nurse still working here that opened that first coronary care unit. It was a four bed unit, all brand new. The nurses working in there even picked out the furniture, it was great, I loved it. We still did not have ED physicians; we didn’t have a code team like we have these days. So if a patient arrested, it was really up to who ever was working to take care of the patient. I can remember the very first patient that had to be defibrillated when I was on duty. We paged the code which was Dr. Emory then, and the only doctor in the house at the time, Sunday morning, and the only doctor in the house was Dr. Lewis F. Preston, the pediatrician. He came back and I remember him saying “Oh, this is amazing, this is just amazing;” you know because we had already defibrillated the patient and he was back. The patient was awake and talking.
MR. WILCOX: How wonderful.
MRS. MANNING: So it was really, really a good job; a great job.
MR. WILCOX: I have a note here in my file that some of the other nurses that started up coronary care were Alice McLaughlin?
MRS. MANNING: Alice McLaughlin is still my very dear friend.
MR. WILCOX: Helen McDonald and MaryAnn Dennis?
MRS. MANNING: I have no memory of the first person, but MaryAnn Dennis was here in the beginning, yes. I went to high school with MaryAnn.
MR. WILCOX: Is that so?
MRS. MANNING: Yes, so we graduated from high school together. Allis remains a very good friend, she lives in Kentucky. Others I remember that helped start coronary care in addition to myself, Allis McLaughlin, and Mary Ann Dennis, were Esther Weinberger, Mildred Parker, Mary Taylor, Mary Sue Dabbs, and Dorothy “Pete” Ralls.
MR. WILCOX: I am a past user of your coronary care unit, so I really thank you for setting that up!
MRS. MANNING: It was a wonderful thing, I really enjoyed that.
MR. WILCOX: Where did your career here go from there?
MRS. MANNING: From there, I guess in 1975, I came back to work full-time, I had three children by then and decided I needed to come back to work to get a rest! So I came back to work and went to work in the Intensive Care unit, by then it was combined with Coronary Care. There was an intensive care unit and a coronary care unit. I did that for maybe about nine months and then Betty Cantwell appointed me as manager of 4 North, the old 4 North which was a medical unit. The other side of 4 North was 4 South, pediatrics, and then the pediatric head nurse or clinical manager left and I ended up with looking after both pediatrics and the medical floors. I got a little bit of peds and little bit of medicine and then, whenever we opened 3 West, we opened the west wings. 3 West opened about 1977.
MR. WILCOX: Was that the acute care wing?
MRS. MANNING: No, it was 2 West, then 3 West. Two West actually opened first and then a year or so later 3 West opened. It was going to be Telemetry, Cardiac step-down, so I went there. It was a 58 bed unit and we had 4 telemetry monitors, so patients that got out of coronary care came up to our unit and I started the first cardiac rehab program.
MR. WILCOX: Wow, is that so?
MRS. MANNING: Yes, I did that. So it was, I loved that because I got my heart patients back that I loved so much.
MR. WILCOX: Really helped them get back on the street?
MRS. MANNING: And did the cardiac rehab, yes.
MR. WILCOX: I have been going to Rehab classes for eight years. That is a great service of MMC that we still have.
MRS. MANNING: The cardiac rehab I did was mostly education. We didn’t do a lot of the physical therapy part - that really didn’t come about until after that. Oh, gosh, I guess I stayed on 3 West, I was the first manager on 3 West and I was there till I believe 1987 and then I moved into Quality with Micki Camp and we were working with the medical staff on utilization reviews, where the insurance companies were demanding information about patients on a daily or an every other day basis. I did a lot of that. From there I became the Manager of Quality and now I am the Director of Clinical Effectiveness and have been in this role for, I don’t know, about 10 or 11 years now.
MR. WILCOX: Clinical Effectiveness?
MRS. MANNING: Yes, is what my title is.
MR. WILCOX: Is that the same as Outcomes Analysis?
MRS. MANNING: “Outcomes Management” is what we call it here, “Continuum of Care” is what it is called in some places, but in the Covenant System it is “Clinical Effectiveness.” Clinical Effectiveness and Quality, I believe is what we are “about.”
MR. WILCOX: In layman’s terms, do we just try to measure whether the hospital is doing their job they are supposed to do?
MRS. MANNING: I monitor a lot. I do a lot of work with the medical staff, their quality improvement is monitored. I do a lot -- I have case management where we monitor the core measures which are the required elements that we have to submit to the Federal Government every quarter as well as to the Joint Commission all that stuff, we do that. So I have responsibility for that, I also have responsibility for the social workers, and I have responsibility for our Capacity Management Center which is our bed flow and I have infection control and I have medical staff office and I have the Diabetes Center across the street, the outpatient Diabetes and Heart Failure and the Comprehensive Chest Clinic.
MR. WILCOX: Well you have your finger on top of most all the hospital operations?
MRS. MANNING: Well when you have been around this long, you know, I do a lot of work with the medical staff and I have been here as long as or longer than as most of them. I have children older than most of these guys now, so it is a great group to work with and I have a lot of fun working with them.
MR. WILCOX: That is wonderful. How about your any interactions with management? When you first came to the hospital in 1968 Marshall had just come; I guess he had just been here just a year and Ralph was here too?
MRS. MANNING: Yes. I knew Marshall and Ralph; I was heavily involved with Marshall in the first quality improvement effort that we had leading toward our winning the Tennessee Quality Award -- you know all the 4 years we won the level three, and the fifth year we finally won the big one. I worked on all of those, so I had pretty heavy interactions with Marshall and Ralph from the time I was a manager onward.
MR. WILCOX: Is it true Coletta that our hospital really was at the vanguard of this movement towards improved quality, weren’t we one of the first hospitals in the area to embrace this strategy --certainly very successful as witnessed the state award? It seems to me you all were “plowing new ground” with this concept that the hospital needed to be seriously concerned about the quality of the healthcare given, not just helping people get well but really worrying about the quality of how we did it. Can you say something about that?
MRS. MANNING: I sure can. I think we were plowing the new ground as far as healthcare. As a matter of fact the company that we worked with to first do quality improvement told us we were the first hospital that they had worked with.
MR. WILCOX: Qual-Pro? Chuck Holland?
MRS. MANNING: Yes. We were the first hospital and there was a fellow there that I can’t even remember his name now who decided to write a book about Quality and Healthcare and he and I had many, many conversations and faxes and phone calls back and forth about how you integrate widgets into people. We also and I did think I was more responsible than anybody in developing our program that we called “CareTrax.” And we were the first hospital in the area to do that.
MR. WILCOX: Can you tell me a little about CareTrax?
MRS. MANNING: What CareTrax is, is just a map for what is going to happen to you while you are in the hospital, so it maps out on day one, day two, day three exactly what medicines and treatment you were going to get.
MR. WILCOX: This is for each patient?
MRS. MANNING: It was for each diagnosis. So we started off with a surgical procedure, a total hip replacement because we do a lot of those and it was a fairly simple one to do. I had one of the doctors partner with me, one of the orthopods, so we started off to trial it just on his patients, but then I took it to the orthopedic section meeting of the medical staff and said “you know here is what we have done, I want you to be aware that you are going to be seeing it on the floors” and wonderful Dr. McMahon who happened to chair the orthopedic section at the time said “well can the rest of us use it?”
MR. WILCOX: Oh how great.
MRS. MANNING: So that was it. It took off immediately and we did things like reduce the length of stay from like eleven days to five days almost immediately. We reduced our cost, standardized the use of antibiotics, and all the other things -- and that is what quality is all about, it’s about standardization. It is decreasing variation and that is what we did with our first CareTrax programs, so they became quite prolific here because it wasn’t very long then before doctors including Dr. Stanley who would say, “Well can you do one for my ‘carotid endarterectomies’ so we just did them and I think we ended up doing about thirty-four procedures.
MR. WILCOX: But you were getting the medical staff on board, that was really the key to it wasn’t it?
MRS. MANNING: Oh yes and actually when Joint Commission came the next year or two years after we had implemented them the physician reviewer with the group said to the docs, “How did you get this, how did this happen?” And Dr. McMahon turned around and pointed at me and said, “She did it”. So it was great.
MR. WILCOX: So rewarding?
MRS. MANNING: Oh very much…
MR. WILCOX: It was a three-way win/win for the hospital and the doctors and the patients?
MRS. MANNING: And the patients because we gave copies of those Trax to the patients saying in layman’s terms, here is what is going to happen to you. If there was an opportunity we would meet with the patient pre-operatively, we did and told them here is what you will be on, here is what is happening.
MR. WILCOX: Take some of the fear out of the process?
MRS. MANNING: Absolutely. Absolutely, And that has evolved, I think they use that concept at least with our total joint center now and those patients are extremely satisfied. They absolutely know what is going to happen to them every minute.
MR. WILCOX: Do we know whether other hospitals in the area have picked up on what we learned.
MRS. MANNING: Well, when we joined Covenant the thing they wanted from us was our CareTrax. It is not the only thing but it was certainly one of the big things they wanted. They had heard of them because of nurses who worked at several different facilities…
MR. WILCOX: Moved around?
MRS. MANNING: They moved around and took a CareTrax with them. I had hospitals from Memphis, hospitals from Crossville that came over here, and said, “Show us your CareTrax, show us how it works, tell us how you did it, how did you get the docs on board.” all that kind of stuff. We don’t have CareTrax anymore because we have gone to electronic medical records, or a lot of it is electronic. We have now is what we call “Care Designs” and it is basically the same thing.
MR. WILCOX: Accomplishes the same thing?
MRS. MANNING: Right, it accomplishes the same thing. But we have all the Covenant facilities now on those.
MR. WILCOX: Great. Wasn’t that a really fine achievement?
MRS. MANNING: Yes, I think that was the one, the one thing that we were truly innovative in. Now 90-95% of the hospitals in the country have some kind of critical pathway or some kind of a system in place. They were actually developed by a nurse, a psychiatric nurse, and she just took the old engineering critical pathway and made it into a kinda medical pathway.
MR. WILCOX: Do you remember other management moves or things that you were involved with the nurses, things in which our hospital was really innovative with, in those years with Ralph and George?
MRS. MANNING: I think there were a lot of things that came about because of team activities. I was a facilitator, one of the first team facilitators and I facilitated many, many teams in this organization. I can remember very clearly one that I did it early on and it was about chest x-rays. The problem was the number of repeat chest x-rays that would have to be taken, where a physician would come in order a chest x-ray, it wouldn’t turn out very well and they would have to repeat it. Well you really don’t want to do that to people very much so --I’m not a radiology person -- I had no idea what was going on but the team had an idea that there was one thing that was causing it, but when we collected the data and worked it over the team we found out it was totally something else. Something totally different! So we found out that getting the data is so important -- it is so important --, and I always use a phase that I stole from W. Edwards Deming, who was one of the first proponents of statistics in management, his phrase was, “In God we trust, and from all others we require data.”
MR. WILCOX: From all others we require data?
MRS. MANNING: Yes, and I learned that early on that you really have to use this data driven approach. It has to be data driven. I think we have been pretty innovative with getting our medical staff on board with quality improvement. They understood early, early on about the importance of decreasing variation; they understood why CareTrax worked. I would have some of them come back to me and say. “This is just ‘cook-book’ medicine,” and I would say, “You know what, it is and all I want is your recipe because when you take a patient to surgery for an appendectomy there are certain things that you do every single time. That is the recipe. And that is what I want to put on your CareTrax so that we do it right every single time.” That is what quality is. If you improve the quality, your cost will decrease, your length of stay will decrease, and your patient will be happier and you will too. So I think we got our docs on board real early, and as I dealt with other facilities and with physicians from other facilities I thought, “Oh how lucky we are.” I would often come out of those meetings and say to some of our docs, “I sure am glad I work with you.” Because they were already there, we didn’t have to bring them on board like we did with some of the others.
MR. WILCOX: Medical schools, I gather, don’t teach this kind of data gathering or disciplined following of standardized procedures?
MRS. MANNING: No.
MR. WILCOX: Coletta, how do you get the new docs on board, that are coming in continuously to this system?
MRS. MANNING: When they come into here they get orientation with me and they spend a lot of time with me. I make up a notebook for them and I tell them here is what quality is, here is what we have done with it in the past, here is what we expect, here’s our anticipation. We have also aligned some of their goals - especially with contracted services - we try to align their goals with what our goals are. I have been educating them for three years, this is coming down the pike and you are going to have to do it too. Hospitals have to submit this kind of data now to regulators; you are going to have to do it too. Just from the very beginning and with some of those goals that we have said, you know like the use of Care Designs if they use the Care Designs they will met the core measures and I know from the data who has used the system and who has not and we give them feedback data. Paperwork for the last six months is what we send out to them, after I review it. So we give them lots of feedback when they come in, and I am generally having conversations with new docs real frequently, asking, “How is it going? What are you finding? Got any ideas?” And we actually recently hired, in the last six months, we hired one that came from Baptist in our hospitalist program and he brought a couple of forms that we thought were pretty good and so we revamped them just a little bit to meet our needs. He was happy because he had helped and saw his ideas accepted.
MR. WILCOX: You mean see something I got from somewhere else being used?
MRS. MANNING: Oh, absolutely I steal unashamedly.
MR. WILCOX: It must be kind of a shock for some of these new docs to be exposed to this as a requirement of being accredited with our hospital?
MRS. MANNING: Yes. You know a couple of years ago you would get a new doc out of school and you know they are fresh out school and, boy they are so anxious. They have been told to do things a certain way for so long, that they are so anxious to do it their own way but it doesn’t take them long to figure out that now when you are out here and you don’t have that Chief Resident looking down your shoulder or the attending physician looking down at everything, you realize you are on your own. Then they are ready for any help they can get. Maybe my age or my brazenness or something, but I just get after them, they are younger than my children.
MR. WILCOX: Of course you know when to be hard and when to be soft?
MRS. MANNING: You know I think they just trust me. I try to give them any help I can; you know when they say to me could I get so and so, even if it is not my job I try to get it for them. You know I want to give them back as much as I expect to get back from them.
MR. WILCOX: Well, looking back on all your years here, Coletta, what do you think most about in terms of happy experiences that you have had?
MRS. MANNING: I think the most exciting thing has been the change, in the advancement of technology, how fast it has advanced. I mean, I have been here 34 years full time and I think that when I came all of things we were doing were then “state of the art,” but when I look back and I see what we have now I think oh my God, how did we do that? How did we work in that unit taking care of five critically ill patients with one RN and one LPN and no physicians in the house? Yet we did it, so has been wonderful to see the changes in technology. It is wonderful to see that we have house physicians here all the time. It is marvelous to see that we have the great staff of intensivists, and that is pretty innovative in the area. There are very, very few community type hospitals in the country that have a full time intensivist program like we do and we’ve got top notch docs down there working with the critically ill patients that we get helicoptered into us from all around the area, so I think that is what is so surprising.
To think that I remember sitting up on the floor one time back when the hospital didn’t have a respiratory therapy department. Not many hospitals did, but even so we had a patient on a ventilator. I had never had a patient on a ventilator so us two nurses sat down one night up in the old CCU and took apart a ventilator and put it back together till we understood how it worked just in case we got a patient in that we had use it on. All because we did not have a respiratory therapist. Just to think. Wow, now not only do we have a respiratory department but we have a number of respiratory therapists. That is remarkable when I look back. Also remarkable are the things that we can do surgically now. When I got out of school if you had a cataract removed you stayed flat in bed on your back with sand bags on the side of your head, and could not move for two weeks. Now you have it done and go home in a couple hours. And all that change during the time of my career, and that is not like it was back in the 19th century. It is a short time that has gone so fast.
MR. WILCOX: Is the person that is here 38 years from now going be able to look back and see that we made some of the same big changes from where we are today?
MRS. MANNING: I am sure, if the government will let us stay fiscally stable, and if the government will quit taking back all our money. For instance, it is just amazing the amount of information that you get from a 32 slice MRI. And even more in a 64 - and you know about the time we get the 64 one set up I am sure there will be a 120 slice MRI out there or something. You know they just advance so rapidly.
MR. WILCOX: Wonderful. This has been exciting. What else do you want to talk about?
MRS. MANNING: Well, I was a little nervous, I have to say, when you came in because I wasn’t sure what I was going to talk about but…there is a lot. Well it has been interesting to sit through the number of hospital administrations that we have had, but I think we have done remarkably well with all of them. I think we are very lucky to have Mike Belbeck here now; one of the really nice things about this hospital the culture of the administration, it is always a first name basis, it is a friendly hospital.
MR. WILCOX: Easy, relaxed place to work?
MRS. MANNING: Yes, I mean I have had plenty of opportunities to go other places and I don’t think about them, not only because this is my home but because I love working with this medical staff. I love my job. I love the administrative people that I work with. I love my boss, you know and I love my staff. I have a wonderful, wonderful staff.
MR. WILCOX: That is a wonderful testimonial and that is what life ought to be but lots of times it does not. Isn’t that great?
MRS. MANNING: Just the day before yesterday I talked with a case manager who ended up with us after Baptist had their downsizing and she was talking about a physician that they worked with over there and the difference in the ones we work with here and this being a nice place to work. I said, “That is a nice thing to hear, because I have always felt that way.” Of course it has been a long time since I have worked anywhere else, but this is a nice place to be, a nice town to grow up in, it was great town to grow up in and I knew when I left, you know when I got married the first, the only time, I knew when I left if I had children I would come back here to raise them and I did.
MR. WILCOX: That is just very, very nice. I have certainly enjoyed chatting with you and this has been a great interview.
MRS. MANNING: Thank you.
MR. WILCOX: Thank you.
[End of Interview]
METHODIST MEDICAL CENTER ORAL HISTORY:
GEORGE MATHEWS
Interviewed by Pat Clark
August 20, 2008
MRS. CLARK: Pat Clark on August 20, 2008 interviewing George Mathews, former administrator of The Oak Ridge Hospital for the MMC Foundation's history project. George, tell me a little bit about your background I know you are a Virginian.
MR. MATHEWS: Yes, grew up at Front Royal, Warren County, Virginia. I went to school in Virginia. In fact, all of my schooling was in Virginia. I graduated from the Richmond Professional Institute (RPI) and the Medical College of Virginia Hospital Administration Program back in 1960.
MRS. CLARK: Your wife is?
MR. MATHEWS: Karol, she is from Iowa.
MRS. CLARK: Where did you meet?
MR. MATHEWS: We met in California.
MRS. CLARK: Were you working out there?
MR. MATHEWS: I was in the Navy. I met her while I was still in the Navy. Her brother and I were stationed together.
MRS. CLARK: How long was your service in the Navy?
MR. MATHEWS: I was in the Navy four years.
MRS. CLARK: Where did you go from the Navy?
MR. MATHEWS: To college. I came back to Virginia for college. We got married and decided not to make the Navy a career. I decided I better go find something to do. I went to college with the idea of actually going to work at Sears Roebuck and Company after completing college in retail management. During college a friend of mine, that I had known for years, was enrolled in the Medical College of Virginia School of Hospital Administration, and he and I got to talking about it. It looked interesting, so I decided go on to graduate school and try the medical field. That is how I got started in hospital administration.
MRS. CLARK: Ok, that led you into hospital administration. Did you stay in Virginia?
MR. MATHEWS: No, I spent the next 14 years after I graduated in Jacksonville, Florida, at Baptist Hospital in Jacksonville. I came to Knoxville in 1973 and worked for the Baptist Hospital here.
MRS. CLARK: What brought you to Oak Ridge?
MR. MATHEWS: Well, I was in the process of changing jobs. I went to work for Hospital Corporation of America (HCA) at Parkwest Hospital in Knoxville. I had gone out to Martin, Tennessee, as administrator of a small hospital in West Tennessee for HCA, and I was there about a year when I got a call from Ralph Lillard asking if I wanted to come back to East Tennessee. So we talked for a while, and I thought about it a long time. I finally decided to take this job.
MRS. CLARK: What was the job initially?
MR. MATHEWS: The job initially? The hospital had had a consultant in the early 1980’s when it began having difficulty with finances. The Federal Government which had initiated the Medicare program essentially just gave a blank check to hospitals and doctors, and by early 1980’s realized that blank check was getting out of control, so they began putting controls on how hospitals could use Federal Government money for services. The hospitals in the early '80’s began experiencing some financial difficulties making ends meet, because of the payment restrictions that the government began putting on them, primarily in the admission and treatment of the government -sponsored Medicare and Medicaid patients. The hospital here had been doing pretty well but began having some financial difficulties. They called in a consultant who made several recommendations to the hospital. They determined that they could either be a large Harriman type hospital or a country type hospital because of the area that it served, primarily the Oak Ridge area and the surrounding counties up towards Kentucky, or it could become a small University of Tennessee hospital. To be a University of Tennessee hospital would mean developing a physician referral system, and begin trying to put in specialty services that would keep Oak Ridge patients and the patients of surrounding areas coming to physicians here in Oak Ridge and using this hospital, if they needed hospital services, instead of going to Knoxville and UT. The management decided they would rather be a small UT instead of a large Harriman. I came in at the end of that. Ralph Lillard had simply been the operating officer of the hospital until that time, and he wanted someone to come in and take that job, while he, Marshall Whisnant, Rick Stooksbury, and others began working to develop this new hospital system. That is when the Methodist Hospital system came into being.
MRS. CLARK: Oh, it did, in the '80’s.
MR. MATHEWS: That is when I came in as a part of that development. Betty Cantwell [Nursing Administrator] and I pretty much ran the internal operation. The We Care Program, I know you mentioned that, had been adopted earlier. Betty had a lot to do with that.
MRS. CLARK: I think she is going to be interviewed.
MR. MATHEWS: Is she going to be interviewed? Good. Betty was very much a key promoter of that, focusing on taking care of… first of all, the employees who worked here, making sure they were trained and motivated, willing to use their skills on the patients at hand, and then with the idea if we did that they would take good care of patients, and we would develop a reputation for patients to want to come here and have their services. That is sort of what we were to do. I came at the end of November 1985, had my first meeting with the board and with people here, and that is what we did. She and I did that working together for several years until she retired.
MRS. CLARK: How long were you administrator?
MR. MATHEWS: I had several positions. I actually came in with the title as administrator because they wanted me to be seen as the operating officer of the hospital. Actually, I was assistant to Ralph Lillard who was assistant to Marshall Whisnant, who had a real structure of hierarchy here at that time. I did not actually become the Chief Executive Officer of the hospital until after the merger with the Fort Sanders System, to create the Covenant Health System. That was in 1996, I believe, when the merger occurred. For a year I was still in as assistant to Ralph, but when they set up the corporate headquarters in Knoxville, I became the Chief Operating Officer of the Hospital services.
MRS. CLARK: When was that?
MR. MATHEWS: It was 1996 or 1997; 1997 probably.
MRS. CLARK: Ok and how much longer were you here?
MR. MATHEWS: Well, I stayed until September 1998, and at that time they wanted, the system wanted, to develop a corporate compliance program for the whole system. They asked me to do that, to move to Knoxville to do that. They replaced me with Dan Bonk, who was a young administrator working in the system, and Dan became the Chief Executive Officer here. I set that program up and worked with the Integrity and Compliance Office for Covenant Health for about 18 months, setting up the program and getting it started. About that time Dan decided to leave and go back to Milwaukee, Wisconsin. There was some turmoil going on here with the union and the physicians at that time, and so Covenant asked me if I would be willing to come back, until they decided what to do as far as Chief Executive Officer. I did that for 2 more years. I guess I was here from April 1999 until I retired in 2002.
MRS. CLARK: So your total time here was . . .
MR. MATHEWS: About 17, 18 years.
MRS. CLARK: You liked the area well enough to stay.
MR. MATHEWS: Oh, yes. Of course we live now in the Knoxville area, the East Tennessee area since 1973, 35 years.
MRS. CLARK: So you didn’t go back to Virginia?
MR. MATHEWS: Not yet.
MRS. CLARK: Who were some of the doctors and Chiefs of Staff while you were here?
MR. MATHEWS: The Chief of Staff changes every couple of years….but I’ll try to remember who the Chief of Staff was the year I came, and frankly I’m having trouble remembering who that was. Doctor McMahon became Chief of Staff later on. Gene Caldwell was Chief of Staff. I worked with so many of them because they serve as Chief of Staff for a couple years on rotation.
MRS. CLARK: Are there any doctor stories that you could share?
MR. MATHEWS: Well we had (laughter) in fact, not too long after I came the hospital was having difficulty with parking. Parking was always a problem and we decided that, I think I inherited this; we decided that we would tow cars parked illegally in the physician’s parking lot. About the time I came, or not too long afterwards, security actually towed Dr. Larry Dry’s car. He and his staff took up too many parking spaces. Dr. Dry was a member of the medical staff, a surgeon here at that time, and we towed his car in. That really created an uproar! (Laughter). He later actually filed a lawsuit against the hospital, essentially included all the officers and the company for that activity.
MRS. CLARK: How was it resolved?
MR. MATHEWS: It eventually was resolved in a compromised settlement. We never towed anyone else but did retain the parking restrictions.
MRS. CLARK: And Dr. Dry?
MR. MATHEWS: He actually went to school and got a law degree during this period of time and ceased to practice medicine and now practices medical law. In fact, I think he still has an office in this area. That is one story I remember. Actually, this medical staff was a very well trained group of doctors. At one time we probably had more Board certified specialists here percentage -wise for the size of the medical staff, than the hospitals in Knoxville. The recruiting efforts to build this medical staff for referral services actually was attractive and pulled in some very well qualified, trained and credentialed physicians into the area. There was not a great deal of controversy over the medical staff. Certainly there were disagreements and that sort of thing, but usually the emphasis on the We Care Program, the emphasis on really putting patients first, providing the best service, ran through the medical staff too. They supported and helped in those programs and efforts the hospital put together to try to do that.
MRS. CLARK: You must have had some influence on getting well qualified physicians.
MR. MATHEWS: I would like to say that, but not in the early years so much. Physicians would come in to look the place over. I usually would meet with them, show them around, and talk about the hospital services; they were always interested in procuring new tools we would furnish for them to help them attract patients. I spent time there with them, but the recruiting was mostly done by Ralph Lillard during those early years. Toward the end of my time here, particularly after we merged with Covenant, I did get more directly involved with recruiting physicians. Our emphasis then was on continuing to fill the primary care base, family practioners in the outlying areas and Oak Ridge. We worked hard trying to keep orthopedic surgery/ surgeons here, helped bring some of them in, and cardiologists, particularly those two specialties.
MRS. CLARK: Both of which are still strong.
MR. MATHEWS: Yes.
MRS. CLARK: You started a good foundation.
MR. MATHEWS: Yes.
MRS. CLARK: You don’t recall anything else particularly in relation to the medical staff or the nursing staff? Any other problems?
MR. MATHEWS: I guess, with the pressure that was put on by the third party payers, particularly in the government programs to be able to demonstrate that you had high quality service; they began to ask for information about mortality and morbidity. The payers wanted to see evidence that we were not doing things to cause people to die prematurely or leave the hospital in worst condition than they were when they came in. That regulation was tied into the reimbursement from the governmental programs initially and eventually taken up by the private insurance carriers. We had to develop a statistical system that measured the results of our efforts. There was some resistance on the part of the medical staff to put that in place because it called for someone looking over their shoulders. The way we developed it obviously concerned the physicians, so it was important to involve the organized medical staff in developing and implementing it. They certainly agreed they would rather have that done than have some third party do it. One of the initial efforts was to go with an organization called “MedisGroup”; they had the early use of computers. Taking all the information we got out of a patient’s medical records and financial records and dumping it into a computer system, you could then pull data out and know the trends. Checking the financial trends was the biggest use of it. They also looked at the statistical trends of patient outcomes, at least what the outcomes were in the hospital. There was no way to measure what happened after they left here. The Federal government did eventually try to develop information to do that which would give us scorecards to show how we looked compared to others across the country. The doctors really didn’t like that very much, but they did participate in it and helped us do the data gathering and looked at the reports. Based on analysis of the reports we would take some action to correct places where it looked like we may not be doing as good a job as we could. That was aimed primarily at group performance, although obviously you got into some individual performance, and that is where it became touchier than anything else: questioning a doctor’s individual practice, how he is treating his patients, and his relationship with his peers. That was an area where interaction with the medical staff was for the most part positive. Sometimes, we had to take disciplinary action or threaten disciplinary action in some way to change the way of practice, but not often.
MRS. CLARK: It seems to me as though you had to solve many problems, George, with government regulations coming about that time.
MR. MATHEWS: It went from absolutely being in control of the physicians signing an order to have everyone second-guessing and looking at what he was doing, and in some ways restricting what he was doing. When I went to Covenant Health as the Compliance officer in 1998, one of the interesting statistics I ran into was that there were over 130,000 pages of regulations that applied to hospital and physician services. We supposedly had to be in compliance with it all. If not, you would be penalized and not be paid or actually be fined and threatened with losing your practice or even be imprisoned. I never was involved with anyone who actually went to prison, but I was involved with threats of fines and loss of payments. These were some of the big changes that occurred during this period of time at Oak Ridge. One of the better things that happened as a result of the pressure was the development of CareTrax.
MRS. CLARK: Of what?
MR. MATHEWS: CareTrax. This was a continuation of the “We Care” idea, but we began organizing it into what was the best practice that we could use as far as hospital services and physicians' practices in the care of patients with similar diagnosis. One of the restrictions that the government put in early in the 1980's and affected the development before I came here was changing what they would pay for Medicare. It used to be they just paid us “cost plus”. Whatever we billed was “cost plus”. It was audited every year, and we wound up maybe two years after the close of the fiscal year knowing exactly what the government's final payment was. In 1982 they went to paying what they called the “Prospective Payment System” where they developed a payment system based on Diagnostic Related Groups. There were twelve of them. They covered the various medical and basic services that were rendered for patients who had similar diagnoses, and they would pay us retrospectively. We knew whenever one of those patients was admitted what our case rate was going to be for that admission. Certain exceptions were made if someone had a bunch of complications that required more than the usual services. We had to be sure that services covered what the patient needed but no more, because you were only going to get a certain payment. That went on for a while, and finally we came up with and developed CareTrax for certain high resource use diagnosis. We worked with the doctors to develop the system, the things that needed to be done on day 1, day 2, etc, to be certain this patient made progress toward recovery and discharge within a reasonable period of time. Two reasons to do this: one, hopefully, it would be better for the patient, and secondly, it would be better for the payment. It would help us stay within what we would be paid for the patient’s care. This hospital did a really great job working with medical staff. One of the Chiefs of Staff, Dr. Randy Reid, ophthalmologist, helped tremendously, and I think it was during his tenure as Chief of Staff that we really concentrated on that type of managed patient care. He got the medical staff organized to promote this kind of service. He became a consultant with the Horty, Springer consulting firm out of Pittsburgh, Pennsylvania. They put on training programs for hospital medical staff members, teaching how to be a staff officer, and leader, the business aspects of the medical staff, how to deal with physicians who didn’t want to go along with the best way to do things. They actually put on seminars all across the country on medical staff organization. Randy still teaches these seminars.
MRS. CLARK: Well, you saw a lot of changes during your service here.
MR. MATHEWS: Oh yes, when I sometimes think of the changes that occurred in hospital service and medical practices from the time I graduated from college until I retired, it is mind boggling.
MRS. CLARK: You are not sure you would go into the profession now.
MR. MATHEWS: Knowing a little about some of the things going on right now, I would want to take a close look. No, I would still choose the work as I felt good basically about what we did. In college, the graduate school finance course was taught at the University of Richmond rather than Medical College. They essentially told us we are going to teach you all this stuff in corporate finance, some of which I had in college, but your biggest job will be getting the Board to find ways to make up the deficit each year or finding other ways to fund the deficit. That’s what they told us. Then, when I got to the first hospital I worked in, it certainly did not operate that way. They had a big fund- raising program to raise the bottom line or for construction during the time I was there and had a charity program that was funded out of donated funds from the Baptist Church Associations in North Florida. Twenty-one associations worked with them. The hospital had a sound business operation. We had a budget, we had a financial statement, we worried about accounts receivables and the bottom line, even though they told me in college I would not be dealing with that stuff. The hospital administrator this day and time has to pay attention to the business, and it takes up most of his time. At the end of my career that was where I was, and I hated that part of it. I was not all that happy with it, I liked the idea of getting out around where the work was going on, talking with employees, and doctors and seeing what was happening, trying to fix problems they were having doing their jobs. Towards the end, and probably now, I image Mr. Belbeck does not get much chance to get out and do some of things that I did early on. The change was not one that I liked very much, but it was one obviously necessary to do it in order to keep the hospital viable.
MRS. CLARK: Your clerical staff must have really exploded during this time with all the regulations.
MR. MATHEWS: Yes, well of course. When I was in Florida the first few years down there, there were three or four of us on the administrative staff and 12 managers for the hospital and we had a 500 bed hospital. Today there are probably 25 to 30 people doing the same work, well, not the same work but having some of the same responsibilities we had. For instance, I was risk manager /safety and security officer and handled a lot of the non-nursing department responsibilities and that sort of thing. The hospital now has a full-time risk manager.
MRS. CLARK: What was the physical plant like at that time?
MR. MATHEWS: Here, well the hospital had just finished adding the… remember the old lobby had just been rebuilt. They had added two tower floors on the west wing, and Physicians Plaza. They had just gone through a big expansion and renovation program during the early 1980’s, so they had just come out of expanding the hospital.
MRS. CLARK: You mentioned beds before, so about how many beds were here?
MR. MATHEWS: They had had the same number of licensed bed capacity since I first came here: 300, 301 or 302 beds are licensed now. The number being used diminished over the years. We were at an average census of around 150 patients a day, and when I left we were creeping down to 100. I don’t know what it is now. But that is a result of all the emphasis on doing things for patients outside the hospital. After War World II, 1950 – 1960’s the emphasis was on doing it in the hospital; the doctor wanted the patient in the hospital no matter what it was, he wanted the services there and the recovery there. Cataract patients used to stay nine days in the hospital. Now you go in as an outpatient, get it done in the morning, and go play golf in the afternoon, I guess. So the demand was to build more hospitals and Medicare, when it came in 1960’s, just fed the demand for more beds and services. What it did was provide a huge amount of money to expand that system, and that is what happened. Finally the government realized they were expanding a system that was going to eat them alive. So that is when the restrictions started and also at the same time medical science and improved practice made it possible for people to be treated on an outpatient basis, in a doctor’s office or in some kind of organized outpatient program that previously was performed in a hospital room. So we had those changes going on. The less intensive patients were leaving the hospital for outpatient services. During the period of time I was here, and just after the hospital had expanded, we had to build facilities to try to accommodate taking them out of the hospital, like the Cheyenne Surgery Center, the outpatient department over there, the Cancer Center, all those things. That happened and was going on and that reduced the demand for numbers of patients to fill those beds and at the same time there was an emphasis on managed care. I mentioned a while ago…the CareTrax actually reducing the amount of time the patient stayed in the hospital. The open heart surgery patients, for instance, I remember when we first started doing that at Baptist in late 1970’s early 1980’s, generally had an average stay of 15 to 16 days and now it is 4 days. I think something like that if they stay that long.
MRS. CLARK: Where you ever a patient?
MR. MATHEWS: Not while I was the administrator. I have been a patient here since I retired for a couple of days.
MRS. CLARK: How was your care?
MR. MATHEWS: It was fine; they took good care of me. They did all the work-up outside. It used to be they admitted you, did the work -up, then did the surgery, and you stayed here 4 to 5 days. But as it turned out now they did all the work-up before I came in for surgery. I was here 3 days, (I think) then I recovered at home.
MRS. CLARK: I have not mentioned the board. What where your relations with the board?
MR. MATHEWS: Of course, I worked with the board. George Jasny was Board Chairman when I came and George was chairman for a while. Percy Brewington became the chairman after George. I don’t remember when Bill Manly came on the board. One thing that Bill Manly did when he came on the board, he brought his corporate executive experience that he had developed at Carbide and Cabot Corporation, and he insisted on us really tightening up our financial plan. We did that in the early 1990’s and it was really helpful to us. In fact, he helped the hospital weather some pretty severe storms, and if we had not done some of the things he urged us to do, really insisted we do, in the way of building reserves, really looking at the management of our finances, the hospital would probably have been in a lot of trouble in these last years when the reimbursement from payers became less than the cost of providing the services in many cases. If he had not insisted we build up our reserves for a rainy day, the hospital would be in more trouble than it is now. I am sure his counsel is still valuable to the hospital today. It does not sound like it is getting any easier. The latest thing the federal government has done is try to reduce its cost under the umbrella emphasis of better service which continues the pressure on boards and management. Used to be we just took it for granted that some hospitalized patient was going to get an infection. In fact, my thesis in graduate school was on what the Administrator's role might be in the prevention and treatment of hospital acquired infections. Now if a patient, a Medicare patient, gets a hospital acquired infection, it is my understanding that this year or next year, if you can’t prove that something other than hospital technique caused that patient to get an infection, the hospital won’t be paid for it. They will treat the patient but will not be paid for it. As I read the information on it, there are several diagnoses if it looks like something the hospital could have controlled events to prevent what happened, then the program will not pay for the services.
MRS. CLARK: Do you think that might help prevent more infection?
MR. MATHEWS: It all comes out of a study that was done in the late 1990’s that says that you know that hospitals could prevent something like 90,000 premature deaths in a year, if they concentrated on trying to provide a safer service. There is no question that this change in payment is designed to change the mindset that a patient comes in and will probably get an infection. When the patient comes in, we have to prevent them from getting the infection; yes, certainly, that would be better care for the patients.
MRS. CLARK: It wasn’t as much of a problem when you were here?
MR. MATHEWS: Well no. Infection has probably been the post-operative infection and other types of lung infections and things like you can get by just being in the population in a hospital. It has always been a real bug-a-boo. We always thought we were doing our best by cleaning and disinfecting with soaps and sanitizers. Not just washing your hands, but scrubbing them and using antibacterial solutions and things like that so we thought we were doing what we needed to do. But this moves infection control to a whole new level. It would be best to try and prevent it, but if a patient gets it, try to keep it from spreading. Preventing it from happening puts a whole new focus on it than we had faced even though we were concerned about it, cared about it and did not want it to happen, during my entire time as an administrator.
MRS. CLARK: I understand with so many elderly patients coming out of nursing homes to the hospital that they are bringing infection with them.
MR. MATHEWS: The methicillin-resistant Staphylococcus Aurous, which is an infection that we all have on our skin surface and nasal surfaces, and sometimes if you get really sick, it will overpower you if you get the infection. That is what I did my thesis on. Back in the 1960’s, there was an outbreak of this in babies in the newborn nurseries where they began clustering all the babies in one nursery. It became a real problem with it at that time. I picked that up as a thesis to work on with a professor in microbiology as my advisor at the Medical College of Virginia.
MRS. CLARK: Were the results ever published?
No, just my brown copies that I have somewhere in my stuff. They were in the Medical College Library, of course, but I don’t know if they ever did much with it.
MRS. CLARK: Where there any major disappointments that you faced while you were here?
MR. MATHEWS: While I was here, I guess, I don’t know if you call it major or not. I guess the struggle we had over the years from time to time with the union which represented employees here was a source of disappointment. There were times when I thought they didn’t help us with the employees, getting them to see that the hospital was just really not able to do some of the things they wanted, feeling we should do more.
MRS. CLARK: You didn’t face a strike?
MR. MATHEWS: Yes. We …. No one wanted a strike here. In fact Betty Cantwell and I negotiated the first contract in 1986 when the nurses were then represented by Tennessee Nurses Association which switched to the Service Employees International and became an industrial union. There were two bargaining units: one representing the registered nurses and the other all eligible employees. We negotiated two contracts in 1986, and then it was about every three years when we negotiated two new ones the whole time I was here. And all those had their ups and downs; sometimes it was harmonious trying to handle the right problem; sometimes it really got contentious, and the last one with another third party in the picture really came close to a strike. We came so close to having a strike in 1999, the year I came back. We were within two or three hours of a strike. I think everyone blinked when they saw how contentious it was and saw we meant business, that we would not cave in. We gave one little concession, and they took it and avoided a strike. We had made preparations. We actually had contracts with traveling nurses’ companies to bring nurses in to keep the place covered, and we had plans in place to move patients to Knoxville. So it came that close. Since that time I gather they have been able to go back to the type of bargaining that does not raise the temperature to that level. Maybe that particular time scared everybody.
MRS. CLARK: Oh, my goodness…that was a really major problem.
MR. MATHEWS: That was the most contentious one. You ask about disappointment. I guess a major disappointment was realizing organized groups of people are going to look out for their own self-interests, and that may not be best for the hospital.
MRS. CLARK: I don’t know whether we have covered everything, Is there anything you can think of we have not covered?
MR. MATHEWS: One of the great things that happened while I was here, was Marshall Whisnant’s insistence we…. to start with he read a lot. He read Dr. Demings Quality Improvement program to produce better results. The theory was the managers of an organization owned the systems and they need to really work on those to make sure they were working properly so that the people who were doing the actual work could achieve constantly improving results. Marshall insisted we develop something like here. We signed a contract with QualPro down on the Pellissippi Parkway. We went into the training with QualPro; we trained a lot of managers on using statistical measurements to solve problems and to improve operating procedures and to focus on fixing systems, so that people who were doing the work could achieve good results. We focused on taking variation out of processes. For example, the process was used to develop the CareTrax program I mentioned earlier. It finally became a real thing across the country, to try quality improvement in an industry or business to compete nationally and internationally. Anyway the state of Tennessee developed a Quality Award to do the same thing with businesses in the state, and they offered four levels of awards to organizations that could be surveyed, inspected and present data that showed that they were meeting certain levels of quality achievement in their organizational operations. We finally applied for (again at Marshall’s insistence) one of those awards. Lo and behold, we won the first year we tried…we got the quality achievement awards which were the second or third level; I can’t remember the four levels, and we did that for two or three years. Finally in 1997 or 1998 we actually hit the jackpot….we were the first hospital to win the Governor’s Quality Award, which is the highest level you can get in the fourth level for a hospital. Now since that time the hospital has gone after other kinds of recognition, where they demonstrate a certain level of quality service to national organizations. They have won several like that since that time. But that was the most significant thing that happened while I was here, to get that Governor’s Quality Award. It was really great. You wanted me to bring pictures….actually one of the pictures I had were of us in Nashville getting that award, three of us on the stage getting the award.
MRS. CLARK: Bring them by sometime and let Quincy scan them.
MR. MATHEWS: For going over there and getting that award we took quite a number of employees with us and it was really a good feeling to get that award.
MRS. CLARK: Now your title was Chief Administrator?
MR. MATHEWS: The last title after Covenant Health took over. We got to looking at the titles, what we were going to call people, such as the President and Chief Executive Officer of Covenant Health and so the President and Executive Vice President were there. So what do you call the administrators of the hospitals who essentially report to one of these operating officers at Covenant Health? So we came up with the title of President and Chief Administrative Officer in each of the entities. So that was my title when I retired.
MRS. CLARK: What was Marshall Whisnant when you were working here with him?
MR. MATHEWS: He was president. Under the old health system that was developed when I came, Marshall was the president, and he remained that until he retired. Then Ralph Lillard became the president for a short period of time before we actually merged with Fort Sanders Alliance. When that merger occurred, I became the Executive Vice President to Ralph and then after the merger we started looking at titles for the whole organization here and Fort Sanders Hospitals.
MRS. CLARK: I certainly do thank you, George. I think you have shared a lot of information for the archives on how the hospital was operating during your time here. If you do have pictures….
MR. MATHEWS: Yes, I absolutely forgot that you suggested I bring… I did look and I did find a few things. Of course the public relations here have probably more than I have. It’s hard to remember it all. One of the highlights I did like was playing Santa Claus.
MRS. CLARK: You played Santa Claus?
MR. MATHEWS: Yes, Marshall started it out and I shared it at Christmas on Employees' Day. It was and is called “Turkey Day.”
MRS. CLARK: How many pillows did you have to stuff yourself with? I would like to have come to a party then.
MR. MATHEWS: That was sort of a highlight….to play Santa Claus. All of the employees' kids came around and some of the big kids wanted to sit on Santa’s lap and get a picture taken.
[End of Interview]
METHODIST MEDICAL CENTER ORAL HISTORY:
DAVID MCCOY
Interviewed by Quincey Harrington
September 3, 2008
MRS. HARRINGTON: David, tell about how you first came to Oak Ridge?
MR. MCCOY: I came to Oak Ridge after my mother and her husband moved here, a year and a half later in 1951. I lived with my mother and step-father in Lexington, Kentucky, and was talked into coming to Oak Ridge to finish up at Oak Ridge High School. Which was a good thing, I’m glad I did. I had a great time at Oak Ridge High School and I am so glad to see its growing also, like the hospital is growing now. It makes the city look a lot better but I have to say I miss the long halls of the Oak Ridge Hospital before it was Methodist. There is a lot of history that a lot of people nowadays don’t realize what doctors and nurses all went through before this building was built.
MRS. HARRINGTON: Tell us what you know about that.
MR. MCCOY: I do know that they were limited in a lot of areas. A lot of doctors did not have equipment to do the things they needed to do. Many of the patients were sent to Knoxville. Now, Knoxvillians are coming here. I think that is very good.
MRS. HARRINGTON: What do remember of the hospital as a teenager?
MR. MCCOY: It didn’t’ look like a hospital really. They looked like barracks and I guess if you lived back in that area, I was just after the muddy streets and wooden sidewalks so I didn’t get to see all that. But I fell totally in love with Oak Ridge, the way it was right then and as things begin to grow, you sort of look back nostalgically, “Boy, wish it was still that way” but as things change like this beautiful building that everyone is enjoying throughout the community, it’s worth doing. The hospital is one of the key things in any community. I am very proud to have worked here.
MRS. HARRINGTON: Were you ever a patient here?
MR. MCCOY: Oh yes, a couple of times. I injured my knee in a very freak accident and I had a leg operation not long after that. I believe that is the only two times I have been in the hospital.
MRS. HARRINGTON: How long were you in each time?
MR. MCCOY: Five days on one and overnight on the other.
MRS. HARRINGTON: When did you come to work at MMC?
MR. MCCOY: I was here about 8 years, so probably 2000. Earlier I was at the Oak Ridger. I returned back to the Oak Ridger from the Courier News. The call went out for a new, Executive Director for the Foundation. I didn’t feel I was qualified, but I was very pleased the search committee finally chose me to come in and take over. That was a great thing for me. It was a different way of life. I had to learn a lot, but had some good teachers and we moved the Board a little forward.
MRS. HARRINGTON: So who brought you on?
MR. MCCOY: The search committee consisted of Lou Dunlap, Martha Hobson who was the outgoing chair, and the incoming chair for the foundation, and I think I was interviewed twice. You walk away from the interview thinking “I wish I had said this, I wish I’d said that” but whatever it was, it worked.
MRS. HARRINGTON: Who was the CEO at the time?
MR. MCCOY: George Mathews was the CEO and then came Jan McNally. She and Randy, I think, were the two that recommended me for the position.
MRS. HARRINGTON: Who did you follow?
MR. MCCOY: Glen Landy, Glen was director for a number of years here and moved to Oregon? He went to work in a similar position in a different environment of course. I replaced him.
MRS. HARRINGTON: What do you know about the history of the foundation, when it started? Do you know any of that information?
MR. MCCOY: I think the idea was generated, Herman Postma was one and it seems like George Jasny, both are deceased now. Ken Sommerfeld was also a founder. They were very instrumental in working on getting the foundation started. It was an independent foundation at the time, run by the Board, controlled by the Board, the Foundation Board. It was sort of separate from the hospital. I did serve, now that you mention it, on the governing body of the Board of Directors back in the 1980s, I believe it was when Methodist was just Methodist and it was controlled and run by a governing Board of Directors. I represented the county, because I was the publisher of the Courier News. Bill Manly, who was a big supporter of the foundation, was one of the guys that was involved in the beginning, come to think of it. There is a tremendous amount of effort and money put into the foundation. We even named the hospitality house after the Manlys. He built and paid for the Quiet Room in the hospital. His wife was critically ill and finally died. The Quiet Room is a resting place, they put him there, it had gray walls, gray furniture, gray floor and gray everything then he couldn’t stand it. So he went home and got his wife’s favorite painting and brought it down and hung it on the wall and he and Jenny Edgar went on and bought new furniture and everything to match that picture. He paid for it and left a grant, in an endowment of enough money. He left an endowment for that particular room alone, so that every five years, we are to upgrade it, repair anything, and we need to honor that. He gave a tremendous amount of money to the Wellness Place and the Hospitality House. We are very grateful for a donor of that magnitude. I guess probably Bill is still the leading donor in the foundation.
MRS. HARRINGTON: Was he on the Board?
MR. MCCOY: He was going off the Board I believe when I was coming in but he was, prior to that, Chairman of the Board of the hospital.
MRS. HARRINGTON: Who else was on the Board when you came?
MR. MCCOY: I think Ralph Aurin, Ken Sommerfeld, Wanda Craven, and Pat Coffey.
MRS. HARRINGTON: Who were the physicians at that time?
MR. MCCOY: It was Dr. Richard Dew. He recommended Dr. Stanley to replace him when he retired. Stanley has been a very supporting character, I guess you would say.
MRS. HARRINGTON: When you came on, what was the main focus of the foundation? What was your main drive? Which program did you support? Goals?
MR. MCCOY: Well, my goals were to listen to George Mathews. George was CEO when I came on and after he left, Jan took over, so the first day I was here, I was asked to meet with George in the cafeteria for breakfast at 7 o’clock and I was here until 5 p.m. I was eager and excited about being chosen. I really admired George Mathews highly and he proceeded to explain to me, he had an open door policy. He was thrilled I was on board, “Don’t let anything fester. If you have a problem you can’t control and solve, you come and see me and together we will do it.” And boy, it was a beautiful arrangement. He gave me two goals. The first goal was re-institute the golf tournament because his philosophy was that the doctors worked together and sometimes they need to play together and that was a real challenge to me. I thought I can make this happen. I never even worked in one except with the heart fund with Carol Smallridge.
MRS. HARRINGTON: What happened with the golf tournament before?
MR. MCCOY: It died for about 2 or 3 years, it just went away and Bill Fort who was my co-sponsor here and I went to interview a couple of the past chairs who challenged us and said we would never make it happen. Well, as we walked out the restaurant, Bill and I shook hands and decided we’d just received our supreme challenge, let’s go for it. Seven years in a row, when I was here, we did it. We made money every time. Not a whole lot, but I think we made $16,000 to $18,000 a tournament. The main thing was, about 45 golfers of the 85 golfers were doctors of this hospital or surrounding area. The first year we had a little problem because the guys wanted to talk as much as they wanted to play and we had to be the rangers, I’d guess you’d say. “Guys, tee off, it’s your time, and you’re backing up.” The other challenge was George felt that we should have a second hospitality house, and the house next door to the present house was deteriorating. I took a lot of pictures. A lot of the departments did a lot of storing of equipment in it. The floors were sagging.
MRS. HARRINGTON: It was owned by the hospital?
MR. MCCOY: It was owned by the hospital. Prior to that, it was owned by Jim McMahon, pharmacist in Jackson Square who had leased it out to Emory Valley Center. Then it was one of the group homes. I think they outgrew it or something but they left it and it was just dying away. I brought Lou Rabinowitz on board. He was a member of our Board of Directors. He had a tremendous amount of influence with the Knoxville trade and labor council and there were 16 or 17 different trades that put their spare time and money into the townhouse.
MRS. HARRINGTON: CALM stands for?
MR. MCCOY: Collaborative Agreement between Labor and Management.
MRS. HARRINGTON: Who does this involve, management?
MR. MCCOY: The trade unions, like at the plants. They have certain groups that are non- union, but they work with the union and they work together on different projects. It brought them together. It was really wonderful. They took a lot longer and Lou and I got a lot of criticism for it taking so long but my philosophy was you couldn’t look a gift horse in the mouth and a hundred years from now, it’s not going to matter because that building will still be standing.
MRS. HARRINGTON: Who were the key players in CALM?
MR. MCCOY: Key players were Mel Schuster, Ray and David Garcia, electrical. Ray was the president of the painters union. Schuster was over all. I think he and Ray took turns in being in charge of CALM. It was a group all to itself. It had its own bank account. The way that it worked is every laborer at the plant, so many pennies for every hour they worked went to them and they built money up. They put it all into the common house. I have never been prouder than anything. Every time I pass that, I think there is the fact that our celebration, if you remember, I called George personally and said he needs to be there on Sunday, October 22. He said “Why?” Because I just fulfilled my agreement with you.
MRS. HARRINGTON: When did you start on the CALM house?
MR. MCCOY: Four years and running so about 2004.
MRS. HARRINGTON: How did you raise money to do that?
MR. MCCOY: Door to door a lot. We raised enough money and had enough help; I didn’t gather all the money myself. I did some of it but we funded the entire house. Then I was tying my tie one morning and getting ready to come to the office and the news came on and said this lawyer of Knoxville, Gordan Sams, was requesting non-profits to come after amount of money for the national vitamin settlement that four vitamin companies had conspired together and fixed prices on certain vitamins and they got caught at it and it ended up into millions of dollars. I think the Knoxville area or East Tennessee got something like $220,000 dollars. They said there is no official form, just sit down and bleed your heart and send it to Mr. Sams. Well, I put in that I needed $125,000 for the CALM house, explained that and I’ll never forget that weekend. I spent the whole weekend in my office. It was like pulling paper. I don’t like this, I’d throw it away and I’d start over. I became good at hitting the wastebasket. Finally, I decided that I needed $150,000 for the Wellness Place which was also under the wing of the foundation but my goal was to get a van and equipment to get out into the rural communities to people who had no formal medication, tests or anything. I was going around trying to get volunteers, the dentists, some nurses, and different people. I was doing okay in that area, but I lost out on the $150,000. Well, the state, attorney general’s office vetoed $150,000 said I could do that myself but they gave me $37,500 for the CALM house and said I had to complete the project with that amount of money and could not get any more from anybody but it had to be a one time deal. “Whoa!” So I tore it up and then I decided “You know, such a dumb thing”, so I sat down and wrote a letter and took it to the attorney general’s office and said that my project needs a lot more than $37,500, I forget what it was and I could certainly use that $37,500 inside but it was going to have funding also from individuals and I didn’t think it was fair to be reprimanded for something that was not going to work with that amount of money. Two days later I got a phone call from the attorney general’s office staff. She said “McCoy, they voted yesterday to allow you to get that money and they will see you in Nashville next week on Wednesday” so I tore to Nashville and sat in a crowd of a bunch of people. Seventy different non-profits from Bristol to Nashville, I think received that money and we got $37,500. That really set me going. Then we had some individuals including a board member to fulfill an obligation by the funding of different apartments and that is the way that we did it like Leadership Oak Ridge. I was very proud because I was in the class of 2004 and every time Carol Smallridge would hand me the microphone on the bus or in the restaurants or wherever we were, I’d say I was the go-to guy with microphone to get things started and I always included the new apartment we hadn’t named at the time. I was telling people we needed money for this. Well, Mary Yoder, who was in Leadership Oak Ridge, who was also on the MMC Foundation Board of Directors and I were named, she was named Chair and I was named Vice Chair of the fundraiser that each class has to do. They had to vote on what projects they wanted and there were 3 or 4 hanging out there and I had my fingers crossed. They voted to do the fundraiser to support and pay for one of the apartments in the CALM House. That was wonderful. We worked our little fannies off and started the Casino night and that is how that got started. We needed $10,000 and when all the smoke cleared, dust settled and the pennies stopped rolling, we had $10,400. We bought the plaque and gave the $10,000 to the CALM house. We accomplished our mission.
MRS. HARRINGTON: Thus, began one of our annual events as well?
MR. MCCOY: The other annual event I am proud of is the golf tournament. I wish I had renamed it the Phoenix because it was like bringing it back from the ashes.
MRS. HARRINGTON: What did you support in the Wellness Place?
MR. MCCOY: We supported mostly the senior movement. Lynn Burchell was in charge of the Wellness Place and she had a fantastic senior citizen thing going operating at the mall. There was a room in the mall people donated to, and Lynn did a great job of heart checks, blood checks, all this kind of stuff, and exercise around the mall. It was a winner. Then it moved over to the Wellness Place, and she moved with it and kept it going for quite a while and we supported it. Bill Manly was a tremendous supporter of that and gave thousands of dollars for an endowment to keep the Wellness Place going. One quick story about Bill Manly. He was one of the most generous men, he taught me so much. I wished I could live like he lived but I don’t have the bucks. I admired the way he did it. Barbara and I had dinner with him every Monday night for 2-1/2 years at the Bluehound in Oak Ridge. He had a different group of people he met with. He ate there every night of the week, except the weekends. We don’t know what he did on the weekends. Lynn Burchell, director of the Wellness Place, told me she needed a bone density machine and so I had received a $500 check from someone and I put it on it and I said how much do you need? I need $10,000. So I wrote a letter to all the board members, sent it out, two days later, Bill Manly called me. “Why didn’t you talk to me about the bone density machine?” I said, “Are you upset about it?” He said no. He said, “You didn’t need to go to that trouble.” I said, “Oh really.” He said watch your mail. Two days later, I got a check for $10,000 for the bone density machine. That is a lesson in life. Isn’t that great? He was that way all the time.
MRS. HARRINGTON: When did he pass on?
MR. MCCOY: He was 80-years old and I he’s been dead probably three years now. I knew Bill Manly well enough over the three or four years I dealt with him, I would go up and visit him just to get my motor running again and I would take different people like Susan Hand, Jan McNally, just to give him a little attention. I got to be very close with his sister Sonya and her husband who lived in Ohio I noticed he was deteriorating. He was 79 years old and I called Sonya and said “I don’t want to be the bearer of bad news, but your brother is slipping.” She said, “We had felt the same thing. I think it was important that you told us. We need to address that.” They came down and spent a week with him. We went out to dinner and she said, “You’re right.” I said, “I’m telling you one thing right now, he’s waiting for his 80th B-day because he planned a celebration because he made me do it. We rented the entire Bluehound Restaurant for one afternoon/evening, closed it down and filled it with people he hadn’t seen in years and years. It wasn’t long at all until he passed. He was waiting for his 80th B-day. He just turned 80. He saw people he hadn’t seen in years he use to work with. He was a blacksmith-type. He became a very wealthy man; he and another fellow invented something that made him very wealthy. I didn’t know the other guy. When Bill came back to town, he had been here before at the plant and left and then came back.
MRS. HARRINGTON: You dedicated the CALM House on October 22, 2006? Is there is anything that stands out? You did the Golf tournament, CALM House and supported the Wellness Place. Were there any other programs?
MR. MCCOY: We did a lot with that. We collected enough money and supported the Chaplains fund, We Care and we sort of took charge the We Care. I can’t say we took charge but we were very involved and we had a different chairman every year. The one person who stands out the most is Lois Layne. Lois was a wiz in putting together the We Care and every year they exceeded the previous year. When I think back, it really wasn’t work; it was a way of life. But it was a way of life; it was not a job at all. I think I miss that the most, but now I’m doing pretty good at what I’m doing. I always felt like when I went to the foundation, it was like giving a little back to Oak Ridge because I watched so many people, so many years in my position at the Oak Ridger and as they passed on, it just made it necessary to keep the candle lit, I guess you could say. I always felt good about anything we might have accomplished because I knew it was helping somebody and the robot. Talking about the robot, that was a challenge. The corporate office gave a tremendous amount of help but they had never seen a project go that well in that few of months and that was a good thing. The city of Oak Ridge and surrounding areas was really recognizing MMC as a major player. You got to convince these people that you are who you say you are or they are not going to open their pocket books. That was a lesson I learned. I took a lot of lessons from Bill Manly. I have to throw in that Herman Postma thought I wasn’t qualified for this position. He said “McCoy, we want you for who you know and who knows you. You bring them to the table and we will feed them.” And that is what we lived with. I learned a little bit about fundraising and what-have-you, about every book I could find. I was allowed to go to two to three different seminars from Pride Philanthropy group which was big. You didn’t really learn that much but it re-ignited you in being a little bit better and different. Made you keep going. It was worth doing.
MRS. HARRINGTON: How much did you raise for the robot?
MR. MCCOY: One million, three-hundred thousand dollars. I was so proud of that. I’d like to make a comment about Bill Nowlin, who was instrumental in putting the robot together from the utility company and reason being that Bill was an Oak Ridge High School graduate, the student of Benita Albert who is in her own way one of the best teachers ever Oak Ridge has had. Together they clicked and I found out Bill was the one, the sales rep kept saying, “I wish Bill were here. He would have loved seeing this.” I said, “Denise, who in the world are you talking about?” She said, Bill Nowlin, our chief engineer, whatever his title was in California, is the one who was instrumental in developing the robot and he is from Oak Ridge. I ran to my phone book and found his parents on Melvin Road? I called them and said we are having a demonstration starting tomorrow I want to invite you & your husband, Charles, to come at 9:30 because it opens at 10 and we just want you to touch your son’s labor. A few minutes later I get a phone call from Mr. Nowlin. Uh oh, what have I said? He said, “We cannot do this without you asking Benita Albert to come over.” So I said “Ok.” It was after four. I never forgot the afternoon. “I got to find this woman.” Called the high school, the secretary said, you know I just saw her and I think she is still in the building. So she rang her room and Benita was cleaning up things to leave, explained to her what I had. She said without hesitation, what time? Where? I’ll be there. They all three came and I brought Pete Craven and David Coffey in with them. Benita came over and asked it is possible for her to send three of her students every hour to come in and play with it and look at it, know the story behind it and it really kind of chokes when you up to see three different kids every hour with a gleam in their eye. They want to see what somebody from our class has done. They did that for two days and never ever got in the way. We found out later she had given each an extra credit for coming. That was a good thing. More fun. That was a highlight.
MRS. HARRINGTON: For the record, the DaVinci robot, in the beginning was mainly for cardiothoracic surgery and neurological surgery? Doctors that were involved?
MR. MCCOY: Dr. Hall, Dr. Sloan, Dr. Stanley. They were the three main players. All three are still here. Dr. Bill Hall stayed on Jan’s back for so many months, that when he finally quit beating the table and she Okayed it, I wondered often what they talked about after that.
MRS. HARRINGTON: How did it come about that was what you were going to raise the money for?
MR. MCCOY: Best I can remember, Bill Hall really did really pursue this, he had to have it, he was going to Knoxville to Fort Sanders to use theirs, Fort Sanders Regional to use theirs and he had to get in line. He never knew when he was going to take a patient. He convinced Jan. Already getting started and then Jeff Elliott came in and sort of orchestrated part of the campaign. He had been a tremendous fundraiser in the past. He was really sharp on it. Taught me quite a few things. I always thought after this one was over, I felt I knew enough to do another one. I retired before that.
MRS. HARRINGTON: Other machinery, technology that the foundation bought for the hospital?
MR. MCCOY: Yes they did need IMRT, which I thought it was an instrument but it’s a program but it cost $500,000 and wrote the Cancer Center a check for $500,000. When a person needs radiation, it used to be if you needed to have radiation on your nose, your whole face got it. With this process if you have a need for radiation on the nose, it zeros in on just the nose. It’s a much safer process, probably faster and easier. I was very proud when the board tossed it around because four or five months before they finally said let’s do it, I heard all different kinds of combinations on how they can make it happen. I always thought you just write a check and you got the money and finally that is what happened. That is the tough part about being a staff member and not on the Board that I really had no say in that one and was hard to get used to because I’d always want to say something. I learned to keep my mouth shut.
MRS. HARRINGTON: Who were your biggest donors of the robot?
MR. MCCOY: Jan, Jeff Elliot and I approached the Board of MMC Volunteers one morning. We went in shaking like a leaf and asked them to make a donation of $300,000 over a 5-year period to be given by the MMC Volunteers through the gift shop, fundraisers they hold, book sales, jewelry sales, whatever, would they possibly consider doing that? We made our pitch for the Surgical Robot. They said would you please leave the room so we went across the hall to my office and I believe Murrell Hughett came in and said the Volunteers Board has voted unanimously to donate the $300,000 for the robot. One, we got the money, two, it showed that people inside the hospital looked forward to it - and we were able to tell that story. Hard to work with sometimes, but overall it was a grand finale.
MRS. HARRINGTON: Final thoughts about the foundation?
MR. MCCOY: Seeing things that I didn’t know could happen. One thing I liked was that more and more people began to know more and more about the MCC Foundation during my tenure. I believe because we raised a lot of donors and made a lot of noise. Before I came I knew not much about the foundation and nobody else did. One thing I am proud of is now people around the community, robots, casino nights, golf tournaments, CALM house, they all know a little more about the foundation and that makes me prouder than anything. The biggest thing is the people I worked with. Not a job, a way of life. I could go to any department, ask for any favors, on any floor and everybody was always willing to give, how can I help you? The managers always had a meeting on Tuesday morning, and I was given ample time anytime I needed to get up and give a spiel, about We Care, about the foundation, CALM house, about anything I wanted to get across. This is just a grand place to work. One thousand-three hundred people involved in this movement are unbelievable. You don’t see that everywhere. MRS. HARRINGTON: Thank you.
MR. MCCOY: Thank you.
[End of Interview]